ASD is the most common acyanotic heart disease. Clinically distinguishing ostium primum (OP-ASD ) from ostium secundum (OS- ASD) is not an easy task . A Wide fixed split pf S2 , a short systolic murmur and PA pulsations in left second space, a loud P2 and a hyperdyanmic RV occur in both . The following features might give a clue for OP -ASD .
- While OS-ASD is often an isolated anomaly , isolated OP- ASD is very rare.It usually occur as a part of partial or complete AV canal .
- Early onset of symptoms
- Early onset of pulmonary arterial hypertension( PAH )
- Extra murmur of 1.VSD 2.MR (Cleft mitral valve ) may be present
- Biventricular enlargement (MR/VSD)
- ECG -Left axis deviation -Structural defect in left bundle ?
Confirmation is by Echocardiography and angiogram is rarely required today . Documentation of classical goose neck deformity of LV outflow confirms the diagnosis.