Pediatrics - Congenital Abnormalities

Atrial Septal Defect 700 Lesson

patient thorax when auscultating by stethoscope

The patient was supine during auscultation.

Description

Atrial Septal Defect is a congenital condition associated with abnormal blood flow between the left atrium and the right atrium. Before birth there is a large connection between right and left atria. During fetal development, the connection gradually disappears. However, in some cases, this opening persists and is known as an atrial septal defect.

Both the first and second heart sounds are split. The second heart sound splitting is fixed at 80 milliseconds. There is a brief diamond-shaped murmur in early systole and another brief diamond-shaped murmur in early diastole

This murmur was auscultated at the pulmonic position.

In the cardiac animation video, observe an enlarged right atrium and right ventricle. You see turbulent blood flow across the tricuspid valve between the right atrium and the right ventricle (the diastolic murmur). This is caused by blood flow from the left atrium into the right atrium through the atrial septal defect. There is additional turbulent flow into the pulmonary artery causing the systolic murmur.

Phonocardiogram

Anatomy

Atrial Septal Defect 700

Play the cardiac animation and look for an enlarged right atrium and right ventricle.

Authors and Sources

Authors and Reviewers

Heart sounds by Dr. Jonathan Keroes, MD and David Lieberman, Developer, Virtual Cardiac Patient.
Lung sounds by Diane Wrigley, PA
Respiratory cases: William French
David Lieberman, Audio Engineering
Heart sounds mentorship by >W. Proctor Harvey, MD
Special thanks for the medical mentorship of Dr. Raymond Murphy
Reviewed by Dr. Barbara Erickson, PhD, RN, CCRN.
Last Update: 11/10/2021

Sources

Heart and Lung Sounds Reference Library Diane S. Wrigley
Publisher: PESI
Impact Patient Care: Key Physical Assessment Strategies and the Underlying Pathophysiology
Diane S Wrigley & Rosale Lobo
Practical Clinical Skills: Lung Sounds
PESI Faculty - Diane S Wrigley
Case Profiles in Respiratory Care 3rd Ed, 2019
William A.French
Published by Delmar Cengage
Essential Lung Sounds by William A. French
Published by Cengage Learning, 2011
Understanding Lung Sounds Steven Lehrer, MD
Clinical Heart Disease W Proctor Harvey, MD
Clinical Heart Disease
Laennec Publishing; 1st edition (January 1, 2009)
Heart and Lung Sounds Reference Guide
PracticalClinicalSkills.com