Atrial septal defect history and symptoms: Difference between revisions
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{{Atrial septal defect}} | {{Atrial septal defect}} | ||
{{CMG}}; '''Associate Editor(s)-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, M.B.B.S.]] [mailto: | {{CMG}}; '''Associate Editor(s)-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, M.B.B.S.]] [mailto:psingh13579@gmail.com]; {{CZ}} '''Assistant Editor(s)-In-Chief:''' [[Kristin Feeney|Kristin Feeney, B.S.]] [mailto:kfeeney@elon.edu]; {{YK}} | ||
==Overview== | ==Overview== | ||
The development of symptoms associated with | The development of symptoms associated with atrial septal defect relates to the size and severity of [[left-to-right shunt|intracardiac shunting]] of [[blood]] across the defect. A large atrial septal defect will result in the presentation of [[symptom]]s at a younger age. However, smaller, less severe defects may be asymptomatic until adulthood. Smaller defects cause less hemodynamic disruptions. Symptoms such as [[difficulty breathing]], [[exercise intolerance]] and [[fatigue]] may be seen. As a person ages, the potential for the development of symptoms increases. Adults, especially those over the age of 40, will become symptomatic. Nearly all adults with an atrial septal defect will present with symptom onset by the age of 60. | ||
==History and Symptoms== | ==History and Symptoms== | ||
The presentation of [[atrial septal defect]] depends on size of the defect, [[left-to-right shunt|amount of shunt]], and associated anomalies. Depending on these, the patients can be asymptomatic and get diagnosed incidentally on examination done for other causes. Symptom onset can occur gradually as patient ages and the defect becomes more influential on the heart's functioning.<ref name="pmid5646864">{{cite journal| author=Craig RJ, Selzer A| title=Natural history and prognosis of atrial septal defect. | journal=Circulation | year= 1968 | volume= 37 | issue= 5 | pages= 805-15 | pmid=5646864 | doi= | pmc= | url= }} </ref>. Thus, the patient may present in adulthood with symptoms due to [[right heart failure]], [[pulmonary hypertension]] and [[arrythmia]]s. | The presentation of [[atrial septal defect]] depends on size of the defect, [[left-to-right shunt|amount of shunt]], and associated anomalies. Depending on these, the patients can be asymptomatic and get diagnosed incidentally on examination done for other causes. Symptom onset can occur gradually as patient ages and the defect becomes more influential on the [[heart]]'s functioning.<ref name="pmid5646864">{{cite journal| author=Craig RJ, Selzer A| title=Natural history and prognosis of atrial septal defect. | journal=Circulation | year= 1968 | volume= 37 | issue= 5 | pages= 805-15 | pmid=5646864 | doi= | pmc= | url= }} </ref>. Thus, the patient may present in adulthood with symptoms due to [[right heart failure]], [[pulmonary hypertension]] and [[arrythmia]]s. | ||
===History=== | |||
Specific areas of focus when obtaining a history from the patient include history of:<ref name=ASD>CDC http://www.cdc.gov/ncbddd/heartdefects/atrialseptaldefect.html(2016) Accessed on November 29, 2016</ref> | |||
* Frequent respiratory or lung infections | |||
* Difficulty breathing ([[Dyspnea]]) | |||
* Tiring when feeding (infants) | |||
* [[Shortness of breath]] when being active or exercising | |||
* Skipped heartbeats or a sense of feeling the heartbeat | |||
* Swelling of legs, feet, or stomach area | |||
* [[Stroke]] | |||
===Common Symptoms=== | |||
* [[Shortness of breath]], especially when exercising | * [[Shortness of breath]], especially when exercising | ||
* [[Fatigue]] especially with exertion/exercise | * [[Fatigue]] especially with exertion/exercise | ||
* [[Poor growth]]/[[failure to thrive]] | * [[Poor growth]]/[[failure to thrive]] | ||
* [[Swelling of feet]] and ankle or abdomen ([[right sided heart failure]]) | * [[pedal edema|Swelling of feet]] and ankle or [[ascites|abdomen]] ([[right sided heart failure]]) | ||
* Heart [[palpitation]]s or skipped beats ([[racing heart]], | * Heart [[palpitation]]s or skipped beats ([[racing heart]], awareness of heart beats) | ||
* Recurrent respiratory | * Recurrent [[respiratory infection]]s | ||
===Less Common Symptoms=== | |||
*[[Paralysis|Weakness of different parts of body]] ([[stroke]]) due to [[atrial septal defect paradoxical emboli|paradoxical embolization]]<ref name="pmid3728270">{{cite journal| author=Loscalzo J| title=Paradoxical embolism: clinical presentation, diagnostic strategies, and therapeutic options. | journal=Am Heart J | year= 1986 | volume= 112 | issue= 1 | pages= 141-5 | pmid=3728270 | doi= | pmc= | url= }} </ref><ref name="pmid7634897">{{cite journal| author=Ward R, Jones D, Haponik EF| title=Paradoxical embolism. An underrecognized problem. | journal=Chest | year= 1995 | volume= 108 | issue= 2 | pages= 549-58 | pmid=7634897 | doi= | pmc= | url= }} </ref> | |||
* Weakness of different parts of body ([[stroke]]) due to [[atrial septal defect paradoxical emboli|paradoxical embolization]]<ref name="pmid3728270">{{cite journal| author=Loscalzo J| title=Paradoxical embolism: clinical presentation, diagnostic strategies, and therapeutic options. | journal=Am Heart J | year= 1986 | volume= 112 | issue= 1 | pages= 141-5 | pmid=3728270 | doi= | pmc= | url= }} </ref> | |||
* [[Migraine]] | * [[Migraine]] | ||
* | * Bluish skin color or [[cyanosis]] | ||
===Rapidity of Symptom Onset=== | |||
Atrial septal defect patients are often asymptomatic until later in life. The majority of people with atrial septal defects may not experience any symptoms until after the age of 40. Nearly all atrial septal defect patients will manifest symptoms by the age of 60. Symptoms may become more rapid in onset as patients get progressively older. | Atrial septal defect patients are often asymptomatic until later in life. The majority of people with atrial septal defects may not experience any symptoms until after the age of 40. Nearly all atrial septal defect patients will manifest symptoms by the age of 60. Symptoms may become more rapid in onset as patients get progressively older. | ||
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==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
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[[CME Category::Cardiology]] | |||
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[[Category:Cardiology]] | [[Category:Cardiology]] | ||
[[Category:Congenital heart disease]] | [[Category:Congenital heart disease]] | ||
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[[Category:Embryology]] | [[Category:Embryology]] | ||
[[Category:Disease]] | [[Category:Disease]] | ||
Latest revision as of 16:42, 29 November 2016
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]; Cafer Zorkun, M.D., Ph.D. [3] Assistant Editor(s)-In-Chief: Kristin Feeney, B.S. [4]; Yamuna Kondapally, M.B.B.S[5]
Overview
The development of symptoms associated with atrial septal defect relates to the size and severity of intracardiac shunting of blood across the defect. A large atrial septal defect will result in the presentation of symptoms at a younger age. However, smaller, less severe defects may be asymptomatic until adulthood. Smaller defects cause less hemodynamic disruptions. Symptoms such as difficulty breathing, exercise intolerance and fatigue may be seen. As a person ages, the potential for the development of symptoms increases. Adults, especially those over the age of 40, will become symptomatic. Nearly all adults with an atrial septal defect will present with symptom onset by the age of 60.
History and Symptoms
The presentation of atrial septal defect depends on size of the defect, amount of shunt, and associated anomalies. Depending on these, the patients can be asymptomatic and get diagnosed incidentally on examination done for other causes. Symptom onset can occur gradually as patient ages and the defect becomes more influential on the heart's functioning.[1]. Thus, the patient may present in adulthood with symptoms due to right heart failure, pulmonary hypertension and arrythmias.
History
Specific areas of focus when obtaining a history from the patient include history of:[2]
- Frequent respiratory or lung infections
- Difficulty breathing (Dyspnea)
- Tiring when feeding (infants)
- Shortness of breath when being active or exercising
- Skipped heartbeats or a sense of feeling the heartbeat
- Swelling of legs, feet, or stomach area
- Stroke
Common Symptoms
- Shortness of breath, especially when exercising
- Fatigue especially with exertion/exercise
- Poor growth/failure to thrive
- Swelling of feet and ankle or abdomen (right sided heart failure)
- Heart palpitations or skipped beats (racing heart, awareness of heart beats)
- Recurrent respiratory infections
Less Common Symptoms
- Weakness of different parts of body (stroke) due to paradoxical embolization[3][4]
- Migraine
- Bluish skin color or cyanosis
Rapidity of Symptom Onset
Atrial septal defect patients are often asymptomatic until later in life. The majority of people with atrial septal defects may not experience any symptoms until after the age of 40. Nearly all atrial septal defect patients will manifest symptoms by the age of 60. Symptoms may become more rapid in onset as patients get progressively older.
References
- ↑ Craig RJ, Selzer A (1968). "Natural history and prognosis of atrial septal defect". Circulation. 37 (5): 805–15. PMID 5646864.
- ↑ CDC http://www.cdc.gov/ncbddd/heartdefects/atrialseptaldefect.html(2016) Accessed on November 29, 2016
- ↑ Loscalzo J (1986). "Paradoxical embolism: clinical presentation, diagnostic strategies, and therapeutic options". Am Heart J. 112 (1): 141–5. PMID 3728270.
- ↑ Ward R, Jones D, Haponik EF (1995). "Paradoxical embolism. An underrecognized problem". Chest. 108 (2): 549–58. PMID 7634897.