Atrial Septal Defect: The Daily PANCE Blueprint

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Atrial Septal Defect: The Daily PANCE Blueprint

A 42-year-old female presents for an annual physical exam with some complaints of fatigue and dyspnea. On physical exam, you appreciate a fixed S2 split. Which of the following is the most likely diagnosis?

A. Ventricular septal defect
B. Mitral regurgitation
C. Aortic stenosis
D. Atrial septal defect
E. Patent ductus arteriosus

Answer and topic summary

The answer is D. Atrial septal defect

Atrial septal defect is the most common congenital heart lesion in adults. People often don’t have symptoms until adulthood. The most common type is ostium secundum. Symptoms include fatigue and dyspnea. A classic physical exam finding on a test would be a systolic ejection crescendo-decrescendo flow murmur @ LUSB with FIXED S2, loud S1. An echocardiography is the initial imaging modality of choice. Keep in mind that a complication of ASD is that the left to right shunt can cause volume and pressure overload of the right heart and pulmonary circulation, leading to pulmonary hypertension.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Cardiology ⇒ Congenital Heart Disease ⇒ Atrial septal defect

Also covered as part of the Pediatric EOR topic list

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