Atrial septal defect echocardiography
Atrial Septal Defect Microchapters | |
Treatment | |
---|---|
Surgery | |
| |
Special Scenarios | |
Case Studies | |
Atrial septal defect echocardiography On the Web | |
American Roentgen Ray Society Images of Atrial septal defect echocardiography | |
Risk calculators and risk factors for Atrial septal defect echocardiography | |
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.
- Transthoracic 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.
Modalities
M-mode | Trans-thoracic Echocardiography (TTE) | Trans-esophageal Echocardiography (TEE) | Contrast Echocardiography | Doppler
Techniques in specific defects: Ostium primum | Ostium secundum | Sinus venosus | Coronary sinus
ACC / AHA Guidelines- Evaluation of the Unoperated Patient (DO NOT EDIT)[1]
“ |
Class I1. Atrial septal defect (ASD) should be diagnosed by imaging techniques with demonstration of shunting across the defect and evidence of right ventricular (RV) volume overload and any associated anomalies. (Level of Evidence: C) 2. Patients with unexplained RV volume overload should be referred to an adult congenital heart disease (ACHD) center for further diagnostic studies to rule out obscure ASD, partial anomalous venous connection, or coronary sinoseptal defect.(Level of Evidence: C) |
” |
References
- ↑ 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.