Atrial Septal Defect Reference Guide
Atrial Septal Defect
This is an auscultation example of an atrial septal defect as heard at the pulmonic position. 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 development of the fetus the connection gradually disappears. However, in some cases the 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 In the anatomy video you see 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 further turbulent flow into the pulmonary artery causing the systolic murmur.Auscultation Sound From Lesson


Patient Recording


Patient Recording - Half Speed Playback


Position

The patient's position should be supine.
Listening Tips
S1:SplitSystole:Diamond shaped, brief, early murmur
S2:Fixed splitting
Diastole:Diamond shaped, brief, early murmur
Waveform (Phonocardiogram)
Observe Cardiac Animation
Play the cardiac animation and look for an enlarged right atrium and right ventricle.
Atrial Septal Defect | Description, Audio and Animations | #110
Authors and Reviewers
Authored by Dr. Jonathan Keroes, MD and Diane Wrigley, PA.Medically reviewed by Dr. Barbara Erickson, PhD, RN, CCRN.
Last Update: 12/06/2021
Sources
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Heart Sounds and Murmurs Across the Lifespan (with CD)
by Dr Barbara Ann Erickson
Publisher: Mosby
ISBN-10: 0323020453; ISBN-13: 978-0323020459 -
Heart Sounds and Murmurs: A Practical Guide with Audio CD-ROM 3rd Edition
Elsevier-Health Sciences Division
Barbara A. Erickson, PhD, RN, CCRN -
Heart Sounds Made Easy with CD-ROM: (with CD-ROM) 2nd Edition
Anthony P. Salmon
ISBN-13: 978-0443069079 - NCBI Review of Heart Sounds and Murmurs: A Practical Guide
-
The Virtual Cardiac Patient: A Multimedia Guide to Heart Sounds And Murmurs
Jonathan Keroes, David Lieberman
Publisher: Lippincott Williams & Wilkin)
ISBN-10: 0781784425; ISBN-13: 978-0781784429 -
Ventricular Function Curves in the Exercising Dog
JONATHAN KEROES , ROGER R. ECKER , and ELLIOT RAPAPORT
Circulation Research, Vol. 25, No. 5 -
Electrocardiographic changes associated with ritodrine-induced maternal tachycardia and hypokalemia
American Journal of Obstetrics Gynecology, VOLUME 154, ISSUE 4, P921-923, APRIL 01, 1986
Susan K Hendricks, MD, Jonathan Keroes, MD, Michael Katz, MD -
A Multimedia Guide to Heart Sounds and Murmurs
January 2007 JAMA The Journal of the American Medical Association 297(2):217-218
DOI:10.1001/jama.297.2.217. M. Saleem Seyal, MD, Reviewer
Sources
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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
- Essential Lung Sounds
Diane S. Wrigley, PA-C
Published by MedEdu LLC - 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
Stevben Lehrer, MD
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