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khaledsalah
- 1. ATRIAL SEPTAL DEFECT BY DR.khaled kartella
- 3. DEFINITION • An atrial septal defect is an opening in the atrial septum, or dividing wall between the two upper chambers of the heart known as the right and left atria..
- 5. EMBRYOLOGY • The heart is forming during the first 8 weeks of fetal development.. Atrial septal defects occur when the partitioning process does not occur completely, leaving an opening in the atrial septum.
- 6. HEMODYNAMICS • LARGE VOL OF BLOOD FROM RT.ATRIUM PASSES THRU NORMAL TRICUSPID VALVE & PULMONARY VALVE • DELAYED DIASTOLIC MURMUR(LOW LT STERNAL BORDER) • RT.VENTRICLE ENLARGES • PULMONARY EJECTION MURMUR
- 7. PRESENTATION • recurrent chest infections • fatigue • sweating • rapid breathing • shortness of breath • poor growth
- 8. ON EXAMINATION • INSPECTION • PARASTRNL IMPULSE • PALPATION • SYSTOLIC THRILL AT 2ND LT SPACE
- 9. AUSCULTATION • WIDE FIXED SPLIT S2 • ACCENTUATED P2 • ESM AT LT 2nd & 3rd INTERSPACES • DELAYED DIASTOLIC MURMUR AT LOW LT INTERSPACE
- 10. CXR FINDINGS • MOD. CARDIOMEGALY • RA ENLARGEMENT • RV ENLARGEMENT • PROMINENT MAIN PULM ARTERY • PLETHORIC
- 11. ECG CHANGES • RT AXIS DEVIATION • RT VENT HYPERTROPHY • rsR’ PATTERN IN V1
- 12. ECHO PICTURES
- 13. COMPLICATION • PULMONARY HYPERTENSION(ABOVE 20 YEARS) • DISAPPEARANCE OF DIASTOLIC MURMUR • APPEARANCE OF PULM EJECN CLICK • LOUD PALPABLE P2 • P2_STILL WIDELY SPLIT
- 14. MANAGEMENT • MEDICAL • ANTIBIOTICS FOR CHEST INFECTIONS • DIGOXIN TO INCREASE WORK OF HEART • DIURETICS TO REDUCE PRELOAD
- 16. REPAIR
- 17. ROBO REPAIR