Atrial septal defect electrocardiogram: Difference between revisions
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==Overview== | ==Overview== | ||
Electrocardiogram may be used as a diagnostic tool in the evaluation of an atrial septal defect. ECG findings associated with an atrial septal defect may include PR prolongation (first degree heart block), [[right bundle branch block]], [[right ventricular hypertrophy]], left and [[right axis deviation]], [[atrial fibrillation]], [[atrial flutter]], and [[junctional rhythm|junctional rhythms]]. | Electrocardiogram may be used as a diagnostic tool in the evaluation of an atrial septal defect. ECG findings associated with an atrial septal defect may include PR prolongation ([[first degree heart block]]), [[right bundle branch block]], [[right ventricular hypertrophy]], left and [[right axis deviation]], [[atrial fibrillation]], [[atrial flutter]], and [[junctional rhythm|junctional rhythms]]. | ||
==Electrocardiography== | ==Electrocardiography== | ||
Revision as of 19:18, 22 August 2011
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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]]
Overview
Electrocardiogram may be used as a diagnostic tool in the evaluation of an atrial septal defect. ECG findings associated with an atrial septal defect may include PR prolongation (first degree heart block), right bundle branch block, right ventricular hypertrophy, left and right axis deviation, atrial fibrillation, atrial flutter, and junctional rhythms.
Electrocardiography
The ECG findings in atrial septal defect vary with the type of defect present.
- It may be normal with an uncomplicated ASD and a small shunt.
- Individuals with atrial septal defects may have a prolonged PR interval (a first degree heart block). The prolongation of the PR interval is probably due to the enlargement of the atria that is common in ASDs and the increased distance due to the defect itself. The first degree heart block is found to happen more frequently with ostium primum ASD compared to the other types due to the involvement of 'Bundle of His' present in the close proximity of the defect. Both of these can cause an increased distance of internodal conduction from the SA node to the AV node.[1]
- Incomplete and less frequently complete Right Bundle Branch Block (RBBB) is often present.
- Right Ventricular Hypertrophy (RVH) with strain suggests onset of pulmonary hypertension or associated pulmonic stenosis.
- The QRS complex may be slightly prolonged and has a characteristic rSr' or rsR' pattern that is contributed to the disproportionate thickening of the right ventricular outflow tract (the last portion of the ventricle to depolarize).
- 2 out of 3 patients with an ostium secundum ASD have right axis deviation.
- Patients with ostium secundum ASDs often develop atrial fibrillation or atrial flutter, and this occurs with a higher incidence with increasing age and with pulmonary hypertension.
- Ostium primum ASDs are associated with a marked left axis deviation.
- Individuals with a sinus venosus ASD exhibit a left axis deviation of the P wave (not the QRS complex).
- Sinus venosus ASDs are often associated with low atrial and junctional rhythms.
References
- ↑ Clark E, Kugler J (1982). "Preoperative secundum atrial septal defect with coexisting sinus node and atrioventricular node dysfunction". Circulation. 65 (5): 976–80. PMID 7074763.