Apa yang meningkatkan risiko saya terkena atrial septal defect kebocoran bilik jantung? Beberapa kondisi yang bisa meningkatkan seseorang terkena atrial septal defect adalah: Infeksi Rubella. Terkena infeksi rubella campak Jerman selama beberapa bulan pertama kehamilan dapat meningkatkan risiko janin Anda mengalami cacat jantung. Obat, tembakau atau alkohol, atau paparan zat tertentu. Penggunaan obat-obatan tertentu, tembakau, alkohol atau obat-obatan, seperti kokain, selama kehamilan dapat membahayakan janin yang sedang berkembang.
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The secundum atrial septal defect usually arises from an enlarged foramen ovale , inadequate growth of the septum secundum , or excessive absorption of the septum primum.
Symptoms are typically decreased exercise tolerance, easy fatigability, palpitations , and syncope. In medical use, the term "patent" means open or unobstructed. On echocardiography, shunting of blood may not be noted except when the patient coughs. PFO is linked to stroke , sleep apnea , migraine with aura , and decompression sickness.
No cause is established for a foramen ovale to remain open instead of closing naturally, but heredity and genetics may play a role. The mechanism by which a PFO may play a role in stroke is called paradoxical embolism. In the case of PFO, a blood clot from the venous circulatory system is able to pass from the right atrium directly into the left atrium via the PFO, rather than being filtered by the lungs, and thereupon into systemic circulation toward the brain.
Sinus venosus[ edit ] A sinus venosus ASD is a type of atrial septum defect in which the defect involves the venous inflow of either the superior vena cava or the inferior vena cava. It is located at the junction of the superior vena cava and the right atrium. It is frequently associated with anomalous drainage of the right-sided pulmonary veins into the right atrium instead of the normal drainage of the pulmonary veins into the left atrium.
ASD secundum seen as a discontinuation of the white band of the atrial septum. The enlarged right atrium is below. The enlarged pulmonary veins are seen entering the left atrium above.
Common or single atrium[ edit ] Common or single atrium is a failure of development of the embryologic components that contribute to the atrial septal complex. It is frequently associated with heterotaxy syndrome. If the defect involves two or more of the septal zones, then the defect is termed a mixed atrial septal defect. Patients with an uncorrected atrial septal defect may be at increased risk for developing a cardiac arrhythmia, as well as more frequent respiratory infections.
If some of the inert gas-laden blood passes through the PFO, it avoids the lungs and the inert gas is more likely to form large bubbles in the arterial blood stream causing decompression sickness. Initially, this increased blood flow is asymptomatic, but if it persists, the pulmonary blood vessels may stiffen, causing pulmonary hypertension, which increases the pressures in the right side of the heart, leading to the reversal of the shunt into a right-to-left shunt.
Paradoxical embolus[ edit ] Venous thrombus clots in the veins are quite common. Embolizations dislodgement of thrombi normally go to the lung and cause pulmonary emboli. In an individual with ASD, these emboli can potentially enter the arterial system, which can cause any phenomenon attributed to acute loss of blood to a portion of the body, including cerebrovascular accident stroke , infarction of the spleen or intestines , or even a distal extremity i.
This is known as a paradoxical embolus because the clot material paradoxically enters the arterial system instead of going to the lungs.
While the exact mechanism remains unclear, closure of a PFO can reduce symptoms in certain cases. The high frequency of these facts make finding statistically significant relationships between PFO and migraine difficult i. In a large randomized controlled trial , the higher prevalence of PFO in migraine patients was confirmed, but migraine headache cessation was not more prevalent in the group of migraine patients who underwent closure of their PFOs.
This extra blood from the left atrium may cause a volume overload of both the right atrium and the right ventricle. If untreated, this condition can result in enlargement of the right side of the heart and ultimately heart failure. This includes hypertension, which increases the pressure that the left ventricle has to generate to open the aortic valve during ventricular systole , and coronary artery disease which increases the stiffness of the left ventricle, thereby increasing the filling pressure of the left ventricle during ventricular diastole.
The left-to-right shunt increases the filling pressure of the right heart preload and forces the right ventricle to pump out more blood than the left ventricle. This constant overloading of the right side of the heart causes an overload of the entire pulmonary vasculature. Eventually, pulmonary hypertension may develop. The pulmonary hypertension will cause the right ventricle to face increased afterload. The right ventricle is forced to generate higher pressures to try to overcome the pulmonary hypertension.
This may lead to right ventricular failure dilatation and decreased systolic function of the right ventricle. If the ASD is left uncorrected, the pulmonary hypertension progresses and the pressure in the right side of the heart becomes greater than the left side of the heart. This reversal of the pressure gradient across the ASD causes the shunt to reverse - a right-to-left shunt.
Once right-to-left shunting occurs, a portion of the oxygen-poor blood gets shunted to the left side of the heart and ejected to the peripheral vascular system. This causes signs of cyanosis. Heart of human embryo of about 35 days Atrial septal defect with left-to-right shunt Illustration depicting atrial septal defect Diagnosis[ edit ] Abnormal chest X-ray as seen in a patient of atrial septal defect Most individuals with a significant ASD are diagnosed in utero or in early childhood with the use of ultrasonography or auscultation of the heart sounds during physical examination.
The development of signs and symptoms due to an ASD are related to the size of the intracardiac shunt. Individuals with a larger shunt tend to present with symptoms at a younger age.
Adults with an uncorrected ASD present with symptoms of dyspnea on exertion shortness of breath with minimal exercise , congestive heart failure , or cerebrovascular accident stroke.
They may be noted on routine testing to have an abnormal chest X-ray or an abnormal ECG and may have atrial fibrillation. If the ASD causes a left-to-right shunt, the pulmonary vasculature in both lungs may appear dilated on chest X-ray, due to the increase in pulmonary blood flow. Upon auscultation of the heart sounds , a systolic ejection murmur may be heard that is attributed to the pulmonic valve, due to the increased flow of blood through the pulmonic valve rather than any structural abnormality of the valve leaflets.
In unaffected individuals, respiratory variations occur in the splitting of the second heart sound S2. During respiratory inspiration, the negative intrathoracic pressure causes increased blood return into the right side of the heart. The increased blood volume in the right ventricle causes the pulmonic valve to stay open longer during ventricular systole. This causes a normal delay in the P2 component of S2. During expiration, the positive intrathoracic pressure causes decreased blood return to the right side of the heart.
The reduced volume in the right ventricle allows the pulmonic valve to close earlier at the end of ventricular systole, causing P2 to occur earlier. In individuals with an ASD, a fixed splitting of S2 occurs because the extra blood return during inspiration gets equalized between the left and right atria due to the communication that exists between the atria in individuals with ASD.
The right ventricle can be thought of as continuously overloaded because of the left-to-right shunt, producing a widely split S2.
Because the atria are linked via the atrial septal defect, inspiration produces no net pressure change between them, and has no effect on the splitting of S2. Echocardiography[ edit ] In transthoracic echocardiography , an atrial septal defect may be seen on color flow imaging as a jet of blood from the left atrium to the right atrium. If agitated saline is injected into a peripheral vein during echocardiography, small air bubbles can be seen on echocardiographic imaging.
Bubbles traveling across an ASD may be seen either at rest or during a cough. Bubbles only flow from right atrium to left atrium if the right atrial pressure is greater than left atrial. Because better visualization of the atria is achieved with transesophageal echocardiography, this test may be performed in individuals with a suspected ASD which is not visualized on transthoracic imaging.
Newer techniques to visualize these defects involve intracardiac imaging with special catheters typically placed in the venous system and advanced to the level of the heart. This type of imaging is becoming more common and involves only mild sedation for the patient typically. If the individual has adequate echocardiographic windows, use of the echocardiogram to measure the cardiac output of the left ventricle and the right ventricle independently is possible.
In this way, the shunt fraction can be estimated using echocardiography. Transcranial doppler bubble study[ edit ] A less invasive method for detecting a PFO or other ASDs than transesophagal ultrasound is transcranial Doppler with bubble contrast. Electrocardiogram[ edit ] The ECG findings in atrial septal defect vary with the type of defect the individual has. Individuals with atrial septal defects may have a prolonged PR interval a first-degree heart block.
The prolongation of the PR interval is probably due to the enlargement of the atria common in ASDs and the increased distance due to the defect itself. Both of these can cause an increased distance of internodal conduction from the SA node to the AV node. A common finding in the ECG is the presence of incomplete right bundle branch block , which is so characteristic that if it is absent, the diagnosis of ASD should be reconsidered.
Atrial septal defect
The secundum atrial septal defect usually arises from an enlarged foramen ovale , inadequate growth of the septum secundum , or excessive absorption of the septum primum. Symptoms are typically decreased exercise tolerance, easy fatigability, palpitations , and syncope. In medical use, the term "patent" means open or unobstructed. On echocardiography, shunting of blood may not be noted except when the patient coughs.
ASD adalah defek pada sekat yang memisahkan atrium kiri dan kanan. Sudigdo Sastroasmoro, ASD adalah penyakit jantung bawaan berupa lubang defek pada septum interatrial sekat antar serambi yang terjadi karena kegagalan fungsi septum interatrial semasa janin. Defek Septum Atrium ASD, Atrial Septal Defect adalah suatu lubang pada dinding septum yang memisahkan jantung bagian atas atrium kiri dan atrium kanan.