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Atrial Septal Defect, Pediatric

Jonathan T. Fleenor, MD, FACC, FAAP Reviewed 10/2018
 


BASICS

DESCRIPTION

  • An opening in the atrial septum, other than a patent foramen ovale (PFO)

  • Four major types of atrial septal defects (ASDs)

    • Secundum ASD

    • Primum ASD

    • Sinus venosus ASD

    • Coronary sinus ASD

  • PFO

    • Us...

DIAGNOSIS

HISTORY

  • Most infants are asymptomatic.

  • Older children with moderate left-to-right shunts are often asymptomatic but may have mild fatigue or dyspnea, especially with exercise.

  • Children with lar...

TREATMENT

GENERAL MEASURES

  • Infants with congestive heart failure should be treated with diuretics.

  • Elective closure is indicated for ASDs associated with large left-to-right shunts, cardiomegaly, or sym...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Children with typical auscultation, chest radiograph, and ECG findings should undergo an echocardiographic evaluation to determine the location ...

ADDITIONAL READING

  • Horton SC, Bunch TJ. Patent foramen ovale and stroke. Mayo Clin Proc.  2004;79(1):79–88. [View Abstract on OvidInsights]

  • Kharouf R, Luxenberg DM, Khalid O, et al. Atrial septal ...

CODES

ICD9

  • 745.5 Ostium secundum type atrial septal defect

  • 745.61 Ostium primum defect

  • 745.8 Other bulbus cordis anomalies and anomalies of cardiac septal closure

ICD10

  • Q21.1 Atrial septal defect

  • Q21.2 Atri...

FAQ

  • Q: When should a moderate secundum ASD be closed?

  • A: This can generally be electively performed in children prior to their starting grade school.

  • Q: What is the significance of a patient having gast...

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