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Presentation of Atrial Septal Defect in the Pediatric Population

机译：小儿房间隔缺损的表现

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摘要

Our recent experience indicates that patients with a hemodynamically significant atrial septal defect secundum (ASD2) do not necessarily present with classic physical and electrocardiographic (ECG) findings. The purpose of the study was to review the records of patients either receiving a catheter device or undergoing surgical repair for the closure of ASD2 to determine their initial physical and ECG findings. Therefore, we did a retrospective review of 47 consecutive patients who had echocardiographic evidence of a hemodynamically significant isolated ASD2 and who underwent ASD2 closure. Of these 47 patients, the presenting complaints were murmur (n = 36), chest pain (n = 6), seizure (n = 1), stroke (n = 1), syncope (n = 1), Kawasaki’s disease (n = 1), and cardiomegaly (n = 1). Charts were reviewed for the evaluation of four abnormal physical findings: hyperactive right ventricular impulse, split fixed second heart sound, systolic and diastolic flow murmurs; and three ECG abnormalities: right axis deviation, right atrial enlargement, and evidence of right ventricular hypertrophy. In all, 30% of patients had either one or no typical physical findings, 18% had normal ECG findings, and 7% had no physical or ECG findings. On physical examination and ECG, the abnormalities due to ASD2 may be too subtle to detect. Although it is well known that variations can occur in the clinical signs and symptoms typical of ASD2, dependence on classical physical and or ECG findings may result in the underdiagnosis of a significant number of patients.
机译：我们最近的经验表明，具有血液动力学显着性房间隔缺损（ASD2 ）的患者不一定具有经典的物理和心电图（ECG）检查结果。这项研究的目的是回顾接受导管设备或接受外科手术以关闭ASD2 的患者的记录，以确定他们最初的身体和心电图检查结果。因此，我们回顾性回顾了47例连续超声心动图检查证实具有血液动力学意义的孤立ASD2 并接受ASD2 封闭治疗的患者。在这47例患者中，主诉为杂音（n = 36），胸痛（n = 6），癫痫发作（n = 1），中风（n = 1），晕厥（n = 1），川崎病（n = 1）和心脏肥大（n = 1）。复查图表以评估四种异常的物理表现：右心室冲动亢进，固定的第二心音分裂，收缩期和舒张期流性杂音；和三个ECG异常：右轴偏离，右房增大和右心室肥大的证据。总计，有30％的患者没有一个或没有典型的体格检查结果，有18％的患者有正常的心电图检查结果，有7％的患者没有身体或心电图结果。在体格检查和心电图检查中，由ASD2 引起的异常可能很难检测到。尽管众所周知，ASD2 的典型临床体征和症状可能会发生变化，但是依赖于经典的身体和/或心电图检查结果可能会导致大量患者的诊断不足。

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  • 来源
    《Pediatric Cardiology》 |2005年第6期|812-814|共3页
  • 作者

    D.D. Christensen; R.N. Vincent; R.M. Campbell;

  • 作者单位

    Department of Pediatrics Sibley Heart Center Cardiology Children’s Healthcare of Atlanta Emory University School of Medicine;

    Department of Pediatrics Sibley Heart Center Cardiology Children’s Healthcare of Atlanta Emory University School of Medicine;

    Department of Pediatrics Sibley Heart Center Cardiology Children’s Healthcare of Atlanta Emory University School of Medicine;

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  • 原文格式 PDF
  • 正文语种 eng
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  • 关键词

    Atrial septal defect; Physical exam- ination; Electrocardiography;

    机译：房间隔缺损;体格检查;心电图检查;

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