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How classical are the clinical features of the “ostium secundum” atrial septal defect?

Published online by Cambridge University Press:  19 August 2008

Stefania Tabery  and
Otto Daniëls
Stefania Tabery
Affiliation:
University Hospital of Nijmegen, Children's Heart Centre, Nijmegen, The Netherlands
Otto Daniëls*
Affiliation:
University Hospital of Nijmegen, Children's Heart Centre, Nijmegen, The Netherlands
*
Dr. O. Daniéls. University Hospiral of Nijmegen, Children's Heart Centre, Geert Grooteplein Zuid 20, 6500 HB Nijmegen, The Netherlands. Tel: +31-24-361 90 60; Fax: +31-24-361 90 52.
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Abstract

Some patients with so called “secundum” atrial septal defect within the oval fossa show a large defect on the echocardiogram, although they do not have all the classical clinical features. Until now, a large atrial septal defect was thought to be characterized by a large shunt (functional defect). Experience indicates, nonetheless, that such large defects in size (anatomical defect) are not always accompanied by large shunts. In order to assess how often the classical clinical features of an atrial septal defect exist, and to investigate whether the surgical indication for closure of the defect are anatomical or functional, we carried out a retrospective study. We evaluated the records of 161 patients, with birth dates from 1973 to 1994 (age between 0 and 21 years), so as to study the classical clinical features (history, physical examination, electrocardiogram, chest X-ray, echo-Doppler studies, cardiac catheterization, surgery). Only patients with an atrial septal defect found in isolation were included.

We discovered that the classical clinical features are often not present when there is a large defect, be it functional or anatomical. The anticipated features are present in roughly two-thirds of the patients. There is also a discrepancy between the anatomical and the functional sizes of the defect. This finding creates a fundamental problem for the future, namely the indications fot closure of atrial septal defects within the oval fossa. Further studies are needed to answer this important question

Keywords

Atrial septal defectdefect within the oval fossaclinical features
Type
Original Articles
Information
Cardiology in the Young , Volume 7 , Issue 3 , July 1997 , pp. 294 - 301
Copyright
Copyright © Cambridge University Press 1997

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References

1.Perloff, JK. The clinical recognition of congenital heartdisease. 4th ed.W.B. Saunders Company, Philadelphia: 1994, 293–322.Google Scholar
2.Van der Werf, T. Cardiovascular pathophysiology. Oxford University Press, Oxford: 1980, 112–123.Google Scholar
3.Anderson, RH, Macartney, FJ, Shinebourne, EA, Tynan, M. Paediatric Cardiology. Churchill Livingstone, Edinburgh: 1987,541–562.Google Scholar
4.Keith, JD, Rowe, RD, Vlad, P. Heart Disease in Infancy and childhood. Macmillan Publishing Co., INC., New York: 1978, 308–404.Google Scholar
5.Dunning, AJ, Meijler, FL, Verheugt, APM. Nederlands leerboek der cardiologie. Tweede herziene druk, tweede oplage. Bohn Stafleu Van Loghum, Houten, The Netherlands: 1992, 264–267.Google Scholar
6.Adams, FH, Emmanouilides, GC. Moss' Heart disease in Infants, Children and Adolescents. 3rd ed.Williams & Wilkins, Baltimore/ondon: 1983, 170–175.Google Scholar
7.Nadas, AS, Fyler, DC. Pediatric cardiology. 3rd ed. illustrated. W.B. Saunders Company, Philadelphia/London/Toronto: 1972,317–334.Google Scholar
8.Feigenbaum, H. Echocardiography. Lea & Febiger, Philadelphia: 1981,364–370.Google Scholar
9.Lundstrõm, NL. Echocardiography in congenital heart didease. J.B. Lippincott Company, Philadelphia: 1978, 173–182.Google Scholar
10.Nugent, EW, Plaut, WH, Edwards, JE, Williams, WH in Hurst's-The Heart. 8th ed (Editors: Schlant, RC, Alexander, RW). McGraw-Hill Inc., United States of America: 1994, 1773–1778.Google Scholar
11.Van den Brande, JL, Van Gelderen, HH, Monnens, LAH. Kindergeneeskunde. Eerste druk, tweede oplage. Wetenschappelijke Uitgeverij Bunge, Utrecht, The Netherlands: 1991.Google Scholar
12.Radzik, D, Van Doesburg, N, Fournier, A, Ducharme, G, Marchand, T, Davignon, A. Predictive factors for spontaneous closure of atrial septal defect diagnosed during the first 3 months of life. Pediatr Cardiol 1992; 13(4):257.Google Scholar
13.Rudolph, AM. Congenital diseases of the heart. Year Book Medical Publishers INC. Chicago: 1974, 239–264.Google Scholar
14.Daniel, WG. Transcatheter closure of patent foramen ovale. Therpapeutic overkill or elegant management for selected patients at risk? Circulation 1992; 86:2013–2015.CrossRefGoogle ScholarPubMed