Knowledge Check: Atrial Septal Defects
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Question 1 of 5
1. Question
Secundum atrial septal defects are defined by defects of which of the following structures?
Hint
A secundum atrial septal defect is due to deficiency of the septum primum. Defects that affect the lumen of the superior or inferior vena cavae are called sinus venosus defects.
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Question 2 of 5
2. Question
Atrial septal defects primarily result in which of the following physiology?
Hint
Shunting is related to the compliance of the two ventricles. After birth the RV becomes more compliant, and allows for blood to shunt left to right through the ASD. Increased compliance leads to the ability to accommodate more blood volume.
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Question 3 of 5
3. Question
Which of the following statements is TRUE regarding how blood flow through the ASD changes as the patient ages from infancy to adulthood?
Hint
Think about the relationship between blood flow at the atrial level and increased ventricular compliance, in which the ventricle with increased compliance is able to accommodate a larger blood volume.
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Question 4 of 5
4. Question
Which of the following scenarios represents the MOST common clinical presentation of an ASD?
Hint
Children with ASDs often present as toddlers during routine well-child check-ups with innocent sounding murmurs heard at the left upper sternal border.
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Question 5 of 5
5. Question
You are examining a 4-year-old child in clinic who has presented for a routine visit. On cardiac exam, you auscultate a II/VI systolic ejection murmur at the left upper sternal border. The child is otherwise asymptomatic and has a normal heart rate and blood pressure. What is the next best step in management of this child?
Hint
The gold standard for diagnosing ASDs include cardiac imaging studies. An ECG and CXR can also be useful in evaluation of heart murmurs in settings where echocardiography is limited.
