Atrial Septal Defect Lesson #700
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
Authors and Sources
Authors and Reviewers
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Heart sounds by Dr. Jonathan Keroes, MD and David Lieberman, Developer, Virtual Cardiac Patient.
- Lung sounds by Diane Wrigley, PA
- Respiratory cases: William French
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David Lieberman, Audio Engineering
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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.
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Last Update: 11/10/2021
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
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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