pediatrics
Atrial Septal Defect (ASD)
Diagnosis of ASD
Chest x-ray and ECG Echocardiography Diagnosis of an atrial septal defect is suggested by cardiac examination, chest x-ray, and ECG and is confirmed by 2-dimensional echocardiography with color flow and Doppler studies. If a significant shunt is present, ECG may show right axis deviation, right ventricular hypertrophy, or right ventricular conduction delay (an rSR′pattern in V1with a tall R′). Chest x-ray shows cardiomegaly with dilation of the right atrium and right ventricle, a prominent main pulmonary artery segment, and increased pulmonary vascular markings. Echocardiography confirms the presence of an ASD, defines the anatomic location and size of the defect, and assesses the degree of right atrial and right ventricular volume overload. Cardiac catheterization is rarely necessary unless transcatheter closure of the defect is planned. 