Atrial septal defect
Background
Clinical Features
A patient may be asymptomatic or have any of the following features:
- Dyspnea on Exertion
- CHF
- Palpitations
- Syncope
- Pulmonary hypertension
- Right heart failure
- A. fib
- Stroke (via an embolism)
- Incomplete right bundle branch block
- Crochetage pattern on ECG in inferior leads (large notches signify a larger shunt)
Differential Diagnosis
Diagnosis
- An ECG may show the “crochetage” pattern (92% specific)—a notch near the apex of the R wave in electrocardiographic (ECG) inferior limb leads[1]
Management
Disposition
- Generally unless there is a complication, the septal defect if found incidentally can be evaluated as an outpatient with elective repair