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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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