RA, RV, and pulmonary artery enlargement; Doppler shows abnormal turbulent transatrial flow. Echo contrast (agitated saline injection into peripheral systemic vein) may visualize transatrial shunt. Transesophageal echo usually diagnostic if transthoracic echo is ambiguous.
Treatment: Atrial Septal Defect In the absence of contraindications an ASD with a significant pulmonary-to-systemic flow (PF:SF) ratio (≥1.5:1.0) should be considered for surgical or percutaneous transcatheter closure. Closure is usually contraindicated with significant pulmonary hypertension and is not undertaken for small defects with trivial left-to-right shunt flow. |