Atrial septal defect echocardiography

Atrial Septal Defect Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Claudia Hochberg, M.D.

Associate Editors-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Keri Shafer, M.D. [3]; Priyamvada Singh, MBBS [[4]]

Assistant Editor-In-Chief: Kristin Feeney, B.S. [[5]]

Overview

Echocardiography may be used as a diagnostic tool in the evaluation of an atrial septal defect. As an evaluative tool, echocardiograms can identify functionality issues within the heart's anatomy. The function of echocardiography in identifying atrial septal defect is to: located and number defects, identify direction of shunting, identify associated anomalies, evaluate atrial and ventricular enlargement. In general, an atrial septal defect patient will present symptomatic evidence of normal blood flow disruptions between the left and right atriums.

Echocardiography

In transthoracic echocardiography, an atrial septal defect may be seen on color flow imaging as a jet of blood from the left atrium to the right atrium.

If agitated saline is injected into a peripheral vein during echocardiography, small air bubbles can be seen on echocardiographic imaging. It may be possible to see bubbles travel across an atrial septal defect either at rest or during a cough. (Bubbles will only flow from right atrium to left atrium if the RA pressure is greater than LA). As better visualization of the atria is achieved with transesophageal echocardiography, this test may be performed in individuals with a suspected atrial septal defect which is not visualized on transthoracic imaging.

Newer techniques to visualize these defects involve intracardiac imaging with special catheters that are typically placed in the venous system and advanced to the level of the heart. This type of imaging is becoming more common and involves only mild sedation for the patient typically.

If the individual has adequate echocardiographic windows, it is possible to use the echocardiogram to measure the cardiac output of the left ventricle and the right ventricle independently. In this way, it is possible to estimate the shunt fraction using echocardiography.

Specific Techniques for ASD

Techniques in specific defects: Ostium primum | Ostium secundum | Sinus venosus | Coronary sinus