​Pathology - Atrial Septal Defect

​Pathology - Atrial Septal Defect
Atrial septal defect is a medical condition characterized by a hole in the wall that separates the two upper chambers of the heart, known as the atria.
Congenital abnormality: linked to trisomies and rubella syndrome.

Pathology: A defect in the wall that separates the two upper chambers of the heart, allowing communication between the right and left atria. There are several variants of this defect, including ostium secundum (75%), which is caused by a defect in the opening of the fossa ovalis; ostium primum (20%), which is associated with Down syndrome, mitral valve defects, and a defect in the lower part of the atrial septum; and sinus venous (5%), which is associated with abnormal return of the right-sided pulmonary veins to the right atrium.

Pathophysiology: Initially, there is a left-to-right shunt caused by the reduced resistance in the pulmonary vasculature compared to the systemic vasculature. The presence of a shunt leads to a continuous increase in the amount of blood flowing to the right side of the heart, which in turn causes a progressive rise in pulmonary vascular resistance. with the potential reversal of the shunt from left to right

Presenting Symptoms
Frequently manifests in adulthood with shortness of breath during physical activity and reduced ability to engage in exercise.
The physical examination indicates a pronounced and unchanging split S2, a murmur during systolic flow in the upper left sternal border, and an elevation of the right ventricle.
Potential consequences of a long-term untreated big atrial septal defect (ASD) encompass pulmonary hypertension, atrial fibrillation, and late cyanosis. Regarding the occurrence of a paradoxical embolism

Administration 
Minor asymptomatic problems can be monitored. Consideration should be given to surgical or percutaneous closure of ASD in patients who are experiencing symptoms or have a shunt fraction greater than 1.5.

Eisenmenger syndrome is characterized by the development of cyanosis in adulthood due to a reversal of blood flow from the left side of the heart to the right side. The condition is a result of untreated, medically severe ventricular septal defects. Autism spectrum disorders (ASDs) and patent ductus arteriosus (PDAs).