Atrial septal defect transthoracic echocardiography
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Priyamvada Singh, M.B.B.S. [2], Cafer Zorkun, M.D., Ph.D. [3]; Assistant Editor-In-Chief: Kristin Feeney, B.S. [4]
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.