Atrial septal defect ostium secundum

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Ostium secundum atrial septal defect

The ostium secundum atrial septal defect is the most common type of atrial septal defect (it accounts for 60%-70% of ASDs), and comprises 6-10% of all congenital heart diseases.

The secundum atrial septal defect usually arises from an enlarged foramen ovale, inadequate growth of the septum secundum, or excessive absorption of the septum primum. 10 to 20 percent of individuals with ostium secundum ASDs also have mitral valve prolapse .[1]

Most individuals with an uncorrected secundum ASD don't have significant symptoms through early adulthood. About 70% develop symptoms by the time they are in their 40s. Symptoms are typically decreased exercise tolerance, easy fatigueability, palpitations, and syncope.

Complications of an uncorrected secundum ASD include pulmonary hypertension, right-sided heart failure, atrial fibrillation or flutter, stroke, and Eisenmenger's syndrome.

While pulmonary hypertension is unusual before 20 years of age, it is seen in 50% of individuals above the age of 40. Progression to Eisenmenger's syndrome occurs in 5 to 10% of individuals late in the disease process.

References

  1. Leachman R, Cokkinos D, Cooley D (1976). "Association of ostium secundum atrial septal defects with mitral valve prolapse". Am J Cardiol. 38 (2): 167–9. PMID 952260.

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