Atrial septal defect: Difference between revisions
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==Diagnosis== | ==Diagnosis== | ||
[[File:crochetage pattern.png|thumbnail|Crochetage pattern on ECG for atrial septal defect]] | [[File:crochetage pattern.png|thumbnail|Crochetage pattern on ECG for atrial septal defect]] | ||
*An ECG may show the “crochetage” | *An ECG may show the “crochetage” pattern (92% specific)—a notch near the apex of the R wave in electrocardiographic (ECG) inferior limb leads<ref>Heller, J et al. “Crochetage” (Notch) on R wave in inferior limb leads: A new independent electrocardiographic sign of atrial septal defect. J Am Coll Cardiol. 1996;27(4):877-882 [http://content.onlinejacc.org/article.aspx?articleid=1121056#tab1 full text]]</ref> | ||
==Management== | ==Management== | ||
Revision as of 20:16, 4 April 2016
Background
Clinical Features
A patient may be asymptomatic or have any of the following features:
- Dyspnea on Exertion
- CHF
- Palpitations
- Syncope
- Pulmonary hypertension
- Right heart failure
- A. fib
- Stroke (via an embolism)
- Incomplete right bundle branch block
- Crochetage pattern on ECG in inferior leads (large notches signify a larger shunt)
Differential Diagnosis
Diagnosis
- An ECG may show the “crochetage” pattern (92% specific)—a notch near the apex of the R wave in electrocardiographic (ECG) inferior limb leads[1]
Management
Disposition
- Generally unless there is a complication, the septal defect if found incidentally can be evaluated as an outpatient with elective repair