Atrial septal defect ostium secundum medical therapy
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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
Definitive treatment of atrial septal defect involves surgical closure of the defect. Medical therapy has a limited role in the management of ASD, and is often used to manage complications like arrhythmia, congestive heart failure and other comorbidities associated with atrial septal defects such as stroke and migraine.
Medical Therapy
There are no widely used guidelines for medical therapy usage in patients with atrial septal defects. Medical therapy in patients of atrial septal defect is administered in certain conditions like arrhythmias [1]. Also, medical therapy can be used to manage conditions associated with atrial septal defects.
- In asymptomatic patients with small shunts and normal right ventricle size generally no medical therapy is required. Routine follow-up assessment of symptoms like arrhythmia, paradoxical embolic events should be done. Also, a repeat echocardiogram should be obtained every 2 to 3 years.
- Treatment of atrial arrhythmia and restoration of sinus rhythm is recommended. In cases with atrial fibrillation, antiarrhythmic and anticoagulation therapy is recommended.
2008 ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease (DO NOT EDIT)[2]
Recommendations for Medical Therapy (DO NOT EDIT)[2]
| Class I |
| "1. Cardioversion after appropriate anticoagulation is recommended to attempt restoration of the sinus rhythm if atrial fibrillation occurs. (Level of Evidence: A) " |
| "2. Rate control and anticoagulation are recommended if sinus rhythm cannot be maintained by medical or interventional means. (Level of Evidence: A)" |
Medical Therapy For Stroke
Medical Therapy For Migraines
References
- ↑ Prystowsky EN, Benson DW, Fuster V, Hart RG, Kay GN, Myerburg RJ; et al. (1996). "Management of patients with atrial fibrillation. A Statement for Healthcare Professionals. From the Subcommittee on Electrocardiography and Electrophysiology, American Heart Association". Circulation. 93 (6): 1262–77. PMID 8653857.
- ↑ 2.0 2.1 Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA; et al. (2008). "ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". J Am Coll Cardiol. 52 (23): e1–121. doi:10.1016/j.jacc.2008.10.001. PMID 19038677.