Atrial septal defect echocardiography

Atrial Septal Defect Microchapters
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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

Echocardiography is the preferred diagnostic tool in the evaluation of an atrial septal defect. As an evaluative tool, echocardiograms can: locate the defects, identify the direction of shunting, identify associated anomalies, evaluate atrial and ventricular enlargement. In general, an atrial septal defect patient will present symptomatic evidence of hemodynamic disruptions between the left and right atriums.

Indications

Echocardiography is the preferred diagnostic imaging method for the evaluation of many congenital heart diseases, including atrial septal defect. An echocardiogram allows for identification of the functional issues with the heart's anatomy. In suspected atrial septal defect patients, an echocardiogram can:

• Locate the defect
• Identify the direction of shunting
• Identify associated anomalies
• Evaluate atrial enlargement
• Evaluate ventricular enlargement

There are many types of echocardiography imaging beneficial for atrial septal defect diagnosis.

Advantages

Echocardiography can provide:

• Direct visualization of the defect in a subcoastal 2-dimension view
• A visualization, when right ventricular volume overload is present, of:

• Pulmonary arterial dilatation
• Right ventricular dilatation
• Anterior systolic/paradoxic septal motion

• Imaging of an associated mitral valve prolapse.

• Transthoracaci echocardiography (TTE) can be used for identification of ostium secundum defects.
• Transesophageal echocardiography (TEE) can aid in identification of:

• Size of defects
• Type of sinus venosus defect (SVC or IVC)
• Any associated anomalies/abnormalities

• Doppler flow echocardiography can identify:

• Shunt ratios
• Shunt volume
• Pulmonary artery pressure

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.

Usage of Echocardiographic Techniques in ASD

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