Atrial septal defect transthoracic echocardiography: Difference between revisions
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__NOTOC__ | |||
{{Atrial septal defect}} | {{Atrial septal defect}} | ||
{{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] | {{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] | ||
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:* Paradoxical motion involving the ventricular septum | :* Paradoxical motion involving the ventricular septum | ||
:* Right atrium enlargement | :* Right atrium enlargement | ||
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| [[Image:Asdb4.jpg|300px|thumb|center|Transthoracic echocardiogram four chamber view to evaluate atrial septal defect. Note presence of inter-atrial communication between left and right atrium.]] || [[Image:Asdafter.jpg|300px|thumb|center|Transesophageal echocardiogram showing Amplatzer device placed across the defect forming a “sandwich” over the atrial septal defect]] || [[Image:Asdafter1day.jpg|300px|thumb|center|Transthoracic echocardiogram four chamber view one day after Amplatzer device placement]] ||[[Image:Asdoneday after.jpg|300px|thumb|center|Transthoracic echocardiogram one day after Amplatzer device placed with highlighted area that shows no further shunting of blood across atrial septum]] | | [[Image:Asdb4.jpg|300px|thumb|center|Transthoracic echocardiogram four chamber view to evaluate atrial septal defect. Note presence of inter-atrial communication between left and right atrium.]] || [[Image:Asdafter.jpg|300px|thumb|center|Transesophageal echocardiogram showing Amplatzer device placed across the defect forming a “sandwich” over the atrial septal defect]] | ||
|} | |||
{| | |||
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| [[Image:Asdafter1day.jpg|300px|thumb|center|Transthoracic echocardiogram four chamber view one day after Amplatzer device placement]] ||[[Image:Asdoneday after.jpg|300px|thumb|center|Transthoracic echocardiogram one day after Amplatzer device placed with highlighted area that shows no further shunting of blood across atrial septum]] | |||
|} | |} | ||
====Advantages==== | |||
==Advantages== | |||
*Determines which type of defect exists. | *Determines which type of defect exists. | ||
*Necessary to evaluate for anomalous pulmonary veins. | *Necessary to evaluate for anomalous pulmonary veins. | ||
*Evaluates for an atrial septal aneurysm. | *Evaluates for an atrial septal aneurysm. | ||
====Disadvantages==== | |||
==Disadvantages== | |||
* Apical four chamber view involves a parallel angle of the echocardiographic beams onto the atrial septum causing artifact in the echo | * Apical four chamber view involves a parallel angle of the echocardiographic beams onto the atrial septum causing artifact in the echo | ||
* Subcostal four chamber view can be ineffective in overweight/obese patients. | * Subcostal four chamber view can be ineffective in overweight/obese patients. | ||
* Size of the defect seen in a TTE does not parallel the measurement of shunt flow from cardiac catheterization. | * Size of the defect seen in a TTE does not parallel the measurement of shunt flow from cardiac catheterization. | ||
====Sensitivity==== | |||
==Sensitivity== | |||
* One study found that subcostal approach could successfully visualize the majority of ostium primum and ostium secundum atrial septal defects.<ref name="pmid6853907">{{cite journal| author=Shub C, Dimopoulos IN, Seward JB, Callahan JA, Tancredi RG, Schattenberg TT et al.| title=Sensitivity of two-dimensional echocardiography in the direct visualization of atrial septal defect utilizing the subcostal approach: experience with 154 patients. | journal=J Am Coll Cardiol | year= 1983 | volume= 2 | issue= 1 | pages= 127-35 | pmid=6853907 | doi= | pmc= | url= }} </ref> | * One study found that subcostal approach could successfully visualize the majority of ostium primum and ostium secundum atrial septal defects.<ref name="pmid6853907">{{cite journal| author=Shub C, Dimopoulos IN, Seward JB, Callahan JA, Tancredi RG, Schattenberg TT et al.| title=Sensitivity of two-dimensional echocardiography in the direct visualization of atrial septal defect utilizing the subcostal approach: experience with 154 patients. | journal=J Am Coll Cardiol | year= 1983 | volume= 2 | issue= 1 | pages= 127-35 | pmid=6853907 | doi= | pmc= | url= }} </ref> | ||
* Visualization of sinus venosus atrial septal defect is less successful, less than 50% of the cases were properly imaged.<ref name="pmid6853907">{{cite journal| author=Shub C, Dimopoulos IN, Seward JB, Callahan JA, Tancredi RG, Schattenberg TT et al.| title=Sensitivity of two-dimensional echocardiography in the direct visualization of atrial septal defect utilizing the subcostal approach: experience with 154 patients. | journal=J Am Coll Cardiol | year= 1983 | volume= 2 | issue= 1 | pages= 127-35 | pmid=6853907 | doi= | pmc= | url= }} </ref> | * Visualization of sinus venosus atrial septal defect is less successful, less than 50% of the cases were properly imaged.<ref name="pmid6853907">{{cite journal|author=Shub C, Dimopoulos IN, Seward JB, Callahan JA, Tancredi RG, Schattenberg TT et al.| title=Sensitivity of two-dimensional echocardiography in the direct visualization of atrial septal defect utilizing the subcostal approach: experience with 154 patients. | journal=J Am Coll Cardiol | year= 1983 | volume= 2|issue= 1 | pages= 127-35 | pmid=6853907 | doi= | pmc= | url= }} </ref> | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
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[[Category:Congenital heart disease]] | [[Category:Congenital heart disease]] | ||
[[Category:Pediatrics]] | [[Category:Pediatrics]] | ||
[[Category: | [[Category:Embryology]] | ||
[[Category:Disease]] | |||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
Revision as of 15:26, 9 January 2013
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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]
For a full discussion on the usage of echocardiography for atrial septal defect diagnosis click here.
Overview
Echocardiography is the preferred diagnostic tool in the evaluation of an atrial septal defect. Trans-thoracic echocardiography is an effective two-dimensional modality that can be used to identify suspected atrial septal defects.
Trans-thoracic echocardiography
- Effective two-dimensional modality for visualizing an ostium secundum atrial septal defect.
- Types:
- Apical four chamber view
- Subcoastal four chamber view
- Provides imaging of:
- Right ventricular enlargement
- Paradoxical motion involving the ventricular septum
- Right atrium enlargement
 |
 |
 |
 |
Advantages
- Determines which type of defect exists.
- Necessary to evaluate for anomalous pulmonary veins.
- Evaluates for an atrial septal aneurysm.
Disadvantages
- Apical four chamber view involves a parallel angle of the echocardiographic beams onto the atrial septum causing artifact in the echo
- Subcostal four chamber view can be ineffective in overweight/obese patients.
- Size of the defect seen in a TTE does not parallel the measurement of shunt flow from cardiac catheterization.
Sensitivity
- One study found that subcostal approach could successfully visualize the majority of ostium primum and ostium secundum atrial septal defects.[1]
- Visualization of sinus venosus atrial septal defect is less successful, less than 50% of the cases were properly imaged.[1]
References
- ↑ 1.0 1.1 Shub C, Dimopoulos IN, Seward JB, Callahan JA, Tancredi RG, Schattenberg TT; et al. (1983). "Sensitivity of two-dimensional echocardiography in the direct visualization of atrial septal defect utilizing the subcostal approach: experience with 154 patients". J Am Coll Cardiol. 2 (1): 127–35. PMID 6853907.