VENTRICULAR SEPTAL DEFECT

ARTRIAL SEPTAL DEFECT

PBP SAKINAH BINTI SHAFFAI

1/2017
 OBJECTIVE
 Introduction of congenital heart defect
 Definition of atrial septal defect (ASD)
 Type of atrial septal defect (ASD)
 Etiology (cause) of atrial septal defect
(ASD)
 Pathophysiology of ASD
 Manifestion clinical of ASD
 OBJECTIVE
 Investigation
 Management
 Nursing care plan & health education
INTRODUCTIONS
 CONGENITAL HEART DEFECT
Congenital heart defects have been
classified into several categories. It divided
into acynotic and cynotic defects.
 Children with acynotic defect may
develop cynocis
 CONGENITAL HEART DEFECT
 Children with cynotic defect may be pink
and have more clinical signs of heart
failure
 More than 35 types of congenital heart
defect have been identified, and some
patient have multiple defects
 CONGENITAL HEART DEFECTS
ACYNOTIC CYNOTIC

↑ Pulmonary Obstruction to ↓Pulmonary Mixed

blood flow blood flow blood flow blood flow
from ventricles

 Coartation of aorta  Transposition of great

 Aortic stenosis arteries
 Pulmonic stenosis  Total anomalous pulmonary
venous return
 Atrial septal defect  Truncus arteriosus
 Ventricular septal defect
 Patent ductus arteriosus  Tetralogy of Fallot Hypoplastic left heart
 Atrioventricular canal  Tricuspid atresia syndrome
ARTRIAL SEPTAL DEFECT
 DESCRIPTION
 Abnormal opening (hole) between the
atria, allowing blood from the higher
pressure (left atrium) to flow into the
lower pressure (right atrium)
 Basicly it is opening in interatrial septum
due to deficiency in septal tissue
There are types of atrial septal defed
(ASD)
Ostium primum atrial septal defect
(ASD 1).

 Opening at lower end of septum, may be

associated with mitral valve
abnormalities
Ostium secundum atrial septal defect.
(ASD 2)

 The most common variety, it affects

about 70 percent of children with the
condition.
 Opening near center of septum

 It occurs when a part of the atrial septum

fails to close completely while the heart
is developing, causing an opening to
develop in the center of the wall
separating the two atria.
Sinus venosus atrial septal defect.

 Opening near junction of the superior vena

cava and right atrium, where the
pulmonary veins enter the heart.

 As a result, the drainage of one or more of

the pulmonary veins may be abnormal,
with the pulmonary veins entering the right
atrium versus the left atrium.
Coronary sinus atrial defect.

 This defect is located within the

coronary, the structure in the right atrium
where all of the heart’s own veins drain
into the right atrium.

 It is the rarest type of ASD

 EPIDEMIOLOGY

 Male : female = 1:2 (unknown reason)

 ETIOLOGY
8weeks of gestation (formation of the
heart)

begins as a hollow tube

it partitions

creating a wall (septum)

 dividing the two side

the partitioning process are not complete

leaving a hole in the atrial septal

atrial septal defect

 ETIOLOGY
 Heredity
 Gene defects : chromosome
abnormalities
 Environmental exposure
 Most artrial septal defect accur by
change with no clear cause
 PATHOPHYSIOLOGY
Left atrial pressure slightly exceeds right
atrial pressure

Blood flow from the left to the right atrium

Increased flow oxygenated blood into the

right side

Low pulmonary vascular resistance and

the greater distensibility of the right atrium
Right atrial enlargement

Cardiac failure
(uncomplicated ASD)
 CLINICAL MANIFESTATION
While each child may experience
symptoms of ASD differently, common
signs include:
 Tiring easily when playing
 Fatigue
 Sweating
 Rapid breathing
 Shortness of breath
 Poor growth
 Frequent respiratory infections
 INVESTIGATIONS
 Chest Xray
• Prominent pulmonary can be seen and
traced upto diaphragm, end on view of
pulmonary artery is seen as white dots
 ECG
• Left axis deviation and prolonged PR
interval – ostium primum
• Inverted P wave – Sinous Venous type
• Prolonged PR interval – Large ASD
 Echocardiogram
• Reveal enlarged right ventricle with
paradoxical septal motion
 MANAGEMENT
 Surgical management
Atrial Septal Defect Device Closure
• Flexible tube (catheter) is inserted into a
blood vessel in the groin and gently
guided to the inside of the heart. Once
the catheter in the heart ,the cardiologist
passes a special device (sepal occular)
 COMPLICATIONS
 Right sided heart failure
 Frequent pulmonary insfections
 Flow – related Pulmonary Atrial
Hypertension
 Pulmonary vascular obstructive disease
 Paradoxical embolism
 Tricuspid and mitral insufficiency
 Atrial arrhytmias