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Texas Heart Institute Journal Feb 2018Methamphetamine abuse is an increasingly prevalent cause of pulmonary artery hypertension in the United States. Conversely, an atrial septal defect rarely presents late...
Methamphetamine abuse is an increasingly prevalent cause of pulmonary artery hypertension in the United States. Conversely, an atrial septal defect rarely presents late as pulmonary artery hypertension. We present the case of a 44-year-old methamphetamine abuser who had a 3-month history of worsening fatigue and near-syncope. She had elevated cardiac enzyme levels and right-sided heart strain. Angiographic findings suggested methamphetamine-induced pulmonary artery hypertension; however, we later heard S irregularities that raised suspicion of an atrial septal defect. Ultimately, the diagnosis was pulmonary artery hypertension and a large secundum atrial septal defect with left-to-right flow. One year after defect closure, the patient was asymptomatic. In addition to discussing this unexpected case of a secundum atrial septal defect masquerading as methamphetamine-induced pulmonary artery hypertension, we briefly review the natural history of atrial septal defects and emphasize the importance of thorough examination in avoiding diagnostic anchoring bias.
Topics: Adult; Cardiac Catheterization; Cardiac Surgical Procedures; Echocardiography, Transesophageal; Female; Heart Septal Defects, Atrial; Humans; Hypertension, Pulmonary; Pulmonary Artery
PubMed: 29556152
DOI: 10.14503/THIJ-17-6208 -
The Journal of Veterinary Medical... Oct 2017An approximately two-year-old, male 6.1 kg body weight, Korean wild raccoon dog (Nyctereutes procyonoides koreensis) was captured by the wildlife medical rescue center...
An approximately two-year-old, male 6.1 kg body weight, Korean wild raccoon dog (Nyctereutes procyonoides koreensis) was captured by the wildlife medical rescue center of Kangwon National University. Upon physical examination, the heart rate was 87 beats per min and there were no clinical signs. The hematological, and blood biochemical profiles revealed no remarkable findings; however, thoracic radiographs showed cardiac enlargement, especially in the right atrium. On electrocardiogram, sinus node dysfunction and bradyarrhythmia were revealed. Echocardiography showed a left-to-right shunting atrial septal defect. Based on these findings, this Korean wild raccoon dog was diagnosed with atrial septal defect. This is the rare case report of atrial septal defect in wildlife.
Topics: Animals; Animals, Wild; Dog Diseases; Dogs; Echocardiography; Electrocardiography; Heart Septal Defects, Atrial; Male; Radiography, Thoracic
PubMed: 28804099
DOI: 10.1292/jvms.17-0217 -
Japanese Circulation Journal May 1997In patients with secundum atrial septal defect, pulmonary hypertension appears to be attributable to microatelectasis of the lung. To confirm this hypothesis, pulmonary...
In patients with secundum atrial septal defect, pulmonary hypertension appears to be attributable to microatelectasis of the lung. To confirm this hypothesis, pulmonary arteries in surgical biopsy specimens from 72 patients with atrial septal defect and pulmonary hypertension were subjected to morphometric examination. Thirty eight of the 72 patients (53%) were found to have microatelectasis of the lung, which suggests that an even higher frequency would have been found if the entire organ had been examined. Atelectatic changes were found in 21 of 39 patients with plexogenic pulmonary arteriopathy (54%), 8 of 15 with musculoelastosis (53%), and 9 of 13 with both of these lesions (69%). No such changes were observed in 5 patients with atrial septal defect who showed thromboembolism-type lesions of the pulmonary arteries. On the other hand, microatelectasis was not observed in another 5 patients with atrial septal defect who did not exhibit pulmonary hypertension. The medial smooth muscles of pulmonary arteries in atelectatic areas were thicker (16.4 +/- 4.0 microns) than those in non-atelectatic areas (10.3 +/- 3.3 microns). The index of pulmonary vascular disease was not significantly different between atelectatic (2.0 +/- 0.6) and non-atelectatic areas (1.9 +/- 0.5). We conclude that in microatelectatic areas, which may tend to develop after respiratory infections in patients with atrial septal defect, hypoxic vasoconstriction of the small pulmonary arteries is liable to occur, which causes hypertrophy of the media. This is likely to lead to the elevation of pulmonary arterial pressure and sustained pulmonary hypertension.
Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Female; Heart Septal Defects, Atrial; Humans; Hyperplasia; Hypertension, Pulmonary; Infant; Male; Middle Aged; Muscle, Smooth, Vascular; Pulmonary Artery; Pulmonary Atelectasis
PubMed: 9192237
DOI: 10.1253/jcj.61.384 -
Revista Espanola de Cardiologia Jun 2009We present the results of two studies that compared surgical treatment and percutaneous intervention in two groups of adult patients: one with atrial septal defects and... (Comparative Study)
Comparative Study Review
We present the results of two studies that compared surgical treatment and percutaneous intervention in two groups of adult patients: one with atrial septal defects and the other with patent ductus arteriosus. In both groups, percutaneous intervention was superior to surgery in terms of patient safety, with fewer immediate and long-term complications.
Topics: Adolescent; Adult; Cardiac Catheterization; Ductus Arteriosus, Patent; Female; Heart Septal Defects, Atrial; Humans; Male; Young Adult
PubMed: 19709533
DOI: 10.1016/s0300-8932(09)72119-0 -
Circulation Feb 2010The primary objective of this study was to develop an image-guided, noninvasive procedure to create or enlarge an atrial septal defect for the treatment of neonates with...
BACKGROUND
The primary objective of this study was to develop an image-guided, noninvasive procedure to create or enlarge an atrial septal defect for the treatment of neonates with hypoplastic left heart syndrome and an intact or restrictive atrial septum. Histotripsy is an innovative ultrasonic technique that produces nonthermal, mechanical tissue fractionation through the use of high-intensity ultrasound pulses. This article reports the pilot in vivo study to create an atrial septal defect through the use of extracardiac application of histotripsy in an open-chest canine model.
METHODS AND RESULTS
In 10 canines, the atrial septum was exposed to histotripsy by an ultrasound transducer positioned outside the heart. Ultrasound pulses of 6-microsecond duration at a peak negative pressure of 15 MPa and a pulse repetition frequency of 3.3 kHz were generated by a 1-MHz focused transducer. The procedure was guided and monitored by real-time ultrasound imaging. In 9 of 10 canines, an atrial septal defect was produced, and shunting across the atrial septum was visualized. Pathology of the hearts showed atrial septal defects with minimal damage to surrounding tissue. No damage was found on the epicardial surface of the heart or other structures.
CONCLUSIONS
Under real-time ultrasound guidance, atrial septal defects were successfully created with extracardiac histotripsy in a live canine model. Although further studies in an intact animal model are needed, these results provide promise of histotripsy becoming a valuable clinical tool.
Topics: Animals; Atrial Septum; Disease Models, Animal; Dogs; Embolism; Heart Septal Defects, Atrial; Humans; Hypoplastic Left Heart Syndrome; Infant, Newborn; Pilot Projects; Risk Factors; Ultrasonics; Ultrasonography, Doppler, Color
PubMed: 20124126
DOI: 10.1161/CIRCULATIONAHA.109.889071 -
European Heart Journal. Cardiovascular... Aug 2022Atrial septal defects (ASD) are associated with atrial arrhythmias, but the arrhythmia substrate in these patients is poorly defined. We hypothesized that bi-atrial...
AIMS
Atrial septal defects (ASD) are associated with atrial arrhythmias, but the arrhythmia substrate in these patients is poorly defined. We hypothesized that bi-atrial fibrosis is present and that right atrial fibrosis is associated with atrial arrhythmias in ASD patients. We aimed to evaluate the extent of bi-atrial fibrosis in ASD patients and to investigate the relationships between bi-atrial fibrosis, atrial arrhythmias, shunt fraction, and age.
METHODS AND RESULTS
Patients with uncorrected secundum ASDs (n = 36; 50.4 ± 13.6 years) underwent cardiac magnetic resonance imaging with atrial late gadolinium enhancement. Comparison was made to non-congenital heart disease patients (n = 36; 60.3 ± 10.5 years) with paroxysmal atrial fibrillation (AF). Cardiac magnetic resonance parameters associated with atrial arrhythmias were identified and the relationship between bi-atrial structure, age, and shunt fraction studied. Bi-atrial fibrosis burden was greater in ASD patients than paroxysmal AF patients (20.7 ± 14% vs. 10.1 ± 8.6% and 14.8 ± 8.5% vs. 8.6 ± 6.1% for right and left atria respectively, P = 0.001 for both). In ASD patients, right atrial fibrosis burden was greater in those with than without atrial arrhythmias (33.4 ± 18.7% vs. 16.8 ± 10.3%, P = 0.034). On receiver operating characteristic analysis, a right atrial fibrosis burden of 32% had a 92% specificity and 71% sensitivity for predicting the presence of atrial arrhythmias. Neither age nor shunt fraction was associated with bi-atrial fibrosis burden.
CONCLUSION
Bi-atrial fibrosis burden is greater in ASD patients than non-congenital heart disease patients with paroxysmal AF. Right atrial fibrosis is associated with the presence of atrial arrhythmias in ASD patients. These findings highlight the importance of right atrial fibrosis to atrial arrhythmogenesis in ASD patients.
Topics: Atrial Fibrillation; Contrast Media; Fibrosis; Gadolinium; Heart Atria; Heart Septal Defects, Atrial; Humans; Magnetic Resonance Imaging; Magnetic Resonance Spectroscopy
PubMed: 34568942
DOI: 10.1093/ehjci/jeab188 -
The Journal of International Medical... Mar 2021Patients with a large congenital atrial septal defect (ASD) traditionally have the ASD repaired at the preschool age. Unfortunately, insufficient education of patients...
Patients with a large congenital atrial septal defect (ASD) traditionally have the ASD repaired at the preschool age. Unfortunately, insufficient education of patients regarding medical science and clinical recommendations can lead to delayed therapy, resulting in complications during adulthood. We report a rare case of a large congenital ASD in a 20-year-old man. Echocardiography showed a 67-mm ostium secundum defect and moderate mitral and tricuspid regurgitation. The patient underwent transthoracic ASD repair along with mitral and tricuspid valvuloplasty. This report emphasizes the importance of educating patients about congenital malformations and potential interventions in developing countries, particularly in rural communities.
Topics: Adult; Cardiac Surgical Procedures; Child, Preschool; Echocardiography; Echocardiography, Transesophageal; Heart Septal Defects, Atrial; Humans; Male; Young Adult
PubMed: 33719647
DOI: 10.1177/0300060521997700 -
BMJ Case Reports Feb 2022We present a case of a previously asymptomatic 63-year-old woman who presented with worsening dyspnoea for 3 weeks. Initial transthoracic and later transoesophageal...
We present a case of a previously asymptomatic 63-year-old woman who presented with worsening dyspnoea for 3 weeks. Initial transthoracic and later transoesophageal echocardiography confirmed biventricular non-compaction cardiomyopathy and a large secundum atrial septal defect (ASD) measuring 1.4 cm. Additionally, there was a haemodynamically significant left to right shunt causing acute decompensated systolic heart failure. She eventually underwent closure of the septal defect using a AMPLATZER Septal Occluder device. Decision to close the defect was made as the left to right shunt was causing severe pulmonary hypertension and acute heart failure. Since most heart failure treatments involve lowering of the LV afterload there was consideration that this could cause right to left shunting and could cause an Eisenmenger physiology. Hence the AMPLATZER Septal Occluder device was placed to eliminate the shunt through the ASD. The ASD combined with the non-compaction posed significant treatment challenge in this case.
Topics: Cardiac Catheterization; Cardiomyopathies; Echocardiography, Transesophageal; Female; Heart Failure; Heart Septal Defects, Atrial; Humans; Middle Aged; Septal Occluder Device; Treatment Outcome
PubMed: 35228224
DOI: 10.1136/bcr-2021-246385 -
Brazilian Journal of Cardiovascular... May 2024Female, seven years old, referred to our service complaining about congestive heart failure symptoms due to mitral valve regurgitation and atrial septal defect....
CLINICAL DATA
Female, seven years old, referred to our service complaining about congestive heart failure symptoms due to mitral valve regurgitation and atrial septal defect. Technical description: Echocardiographic findings compatible with Barlow's disease and atrial septal defect, ostium secundum type.
OPERATION
She was submitted to mitral valvuloplasty with chordal shortening and prosthetic posterior ring (Gregori-Braile®) along with patch atrioseptoplasty.
COMMENTS
Mitral valve regurgitation is a rare congenital heart disease and Barlow's disease is probably rarer. Mitral valve repair is the treatment of choice.
Topics: Humans; Heart Septal Defects, Atrial; Female; Child; Mitral Valve Insufficiency; Echocardiography; Mitral Valve Prolapse
PubMed: 38748990
DOI: 10.21470/1678-9741-2023-0278 -
Journal of Cardiology Jun 2013Heart rate variability (HRV) measures are altered in various cardiac and non-cardiac situations in children. The autonomic nervous system is assumed to have a role in... (Comparative Study)
Comparative Study
OBJECTIVE
Heart rate variability (HRV) measures are altered in various cardiac and non-cardiac situations in children. The autonomic nervous system is assumed to have a role in the pathophysiology of atrial septal defect (ASD). In this study, we evaluated the autonomic system by measuring HRV in children with ASD.
METHODS
Twenty-eight patients with ASD and 32 healthy children (mean ages: 6.6±2.1 years and 6.4±2.2 years, respectively) were enrolled in the study. Twenty-four-hour ambulatory electrocardiographic recordings were obtained and the seven time-domain (SDNN, SDANN, rMSSD, SD, SDNN index, PNN50, and mean RR) and four frequency-domain (VLF, LF, HF, and LF/HF ratio) indices of HRV were analyzed.
RESULTS
A significant decrease in calculated HRV variables was observed in children with ASD as compared to controls. The HRV alteration was found in both time-domain and frequency-domain parameters.
CONCLUSIONS
Our results indicate that HRV is decreased in children with ASD, which implies parasympathetic withdrawal and sympathetic predominance.
Topics: Autonomic Nervous System; Case-Control Studies; Child; Child, Preschool; Cross-Sectional Studies; Electrocardiography, Ambulatory; Female; Heart; Heart Rate; Heart Septal Defects, Atrial; Humans; Male
PubMed: 23618915
DOI: 10.1016/j.jjcc.2013.01.014