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Chapter-12 Atrial Septal Defect with Associated Common Anomalies

BOOK TITLE: Clinical Diagnosis of Congenital Heart Disease

Author
1. Satpathy M
ISBN
9788184481617
DOI
10.5005/jp/books/10126_12
Edition
1/e
Publishing Year
2008
Pages
7
Author Affiliations
1. Haripur Road, Dolamundai, Cuttack, Odisha, India
Chapter keywords

Abstract

When atrial septal defect (ASD) is associated with rheumatic mitral stenosis (MS) the clinical condition is known as Lutembacher’s syndrome. The hemodynamics depends upon which lesion predominates. Patients having mild to moderate lesions of both ASD and MS remain asymptomatic even up to late adulthood. In setting of large ASD if a systolic thrill is palpable over upper left sternal border, clinically associated MS is highly suspected. A continuous murmur may be audible when ASD is small and MS is severe. Echocardiography well demonstrates the site and size of ASD and severity of MS. Surgery is the definite way of management. When one or more but not all four pulmonary veins are connected to RA or systemic veins the condition is known as partial anomalous pulmonary venous connection (PAPVC). The right superior pulmonary vein draining to superior venacava or right atrium is the most common abnormality. Majority of patients are asymptomatic, behave like small ASD. Symptomatic infants having features of ASD with radiological evidence of Scimitar sign belong to infradiaphragmatic type of PAPVC. Echocardiography, particularly TEE showing the abnormal venous connection confirms the diagnosis. Cardiac catheterization and angiography are done before surgery which is the definitive way of management

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