Early Neonatal and Postnatal Diagnostics, Clinical Manifestations, Treatment and Prognosis by Atrial Septal Defect

Abstract

The article presents the published data on the pre­valence, the main clinical manifestations, modern methods of early neonatal and postnatal diagnosis, treatment and prognosis by atrial septal defect — the congenital malformation of cardiovascular system. Atrial septal defects are a group of the congenital heart malformations with typical congenital abnormal junction between left and right atriums. The prevalence of interatrial septum in childhood is one case per 1500 live born, or 7 % among all congenital heart defects. Diagnosis. Small defects are associated with no complains and the defect is usually diagnosed by chance. In comparison with other heart defects auscultatory signs of septal atrium are not evident. Significant defects are associated with such underlying signs as dyspnea and increased fatigue, recurrence bronchitis and pneumonias in anamnesis. The defect is diagnosed after birth or within the first year in 40 % patients. The cardiac borders shift to the right due to increased right atrium and right ventricle. At palpation of the cardiac area systolic thrill is not detected. Moderate systolic murmur is revealed auscultary with maximum in II–III intercostal space on the left. It is not caused by presence and volume of arterial-venous shut, but is a result of right ventricle volume overload and relative stenosis of pulmonary artery. The diagnosis of defect is verified by the changes on electrocardiogram, echocardioscopy and X-ray investigation. Treatment. The most available patient’s age for surgical intervention is 2–12 years old. The newborns with atrial septal defect and congestive heart failure as well as the children with a large defect of atrial septum and heart failure should receive drug therapy.

Keywords

• atrial septal defect
• children