Chest trauma revealed an ostium secundum atrial septal defect in adulthood
Zine el Abidine Benali, Hatim Abdedaim
The Pan African Medical Journal. ;17:29. doi:10.11604/pamj..17.29.3295

Create an account  |  Sign in
PAMJ - Clinical Medicine PAMJ - Clinical Medicine
"Better health through knowledge sharing and information dissemination "

Images in clinical medicine

Chest trauma revealed an ostium secundum atrial septal defect in adulthood

Zine el Abidine Benali, Hatim Abdedaim
Pan Afr Med J. 2014; 17:29. doi:10.11604/pamj.2014.17.29.3295. Published 17 Jan 2014



Atrial septal defect (ASD) is characterized by a defect in the interatrial septum allowing pulmonary venous return from the left atrium to pass directly to the right atrium. ASD account for 10% of all congenital heart disease, and as much as 30 % of congenital heart disease presenting in adulthood. There are four types of ASD that can be recognized as the seat of the port: ostium secundum, the most common, they are located in the area of the oval fossa, and are usually well focused, to differentiate from a patent foramen ovale as in our patient , isolated secundum atrial septal defects account for approximately 7% of congenital cardiac defects ; sinus venosus, high location, near to the anastomosis of the pulmonary veins ; ostium primum , low, can be integrated into a more complete atrioventricular canal ; coronary sinus, a very rare form, this type is a fenestration or a total absence of the roof of the coronary sinus, into the left atrium. In general, elective closure is advised for all ASD with evidence of right ventricular overload or with a clinically significant shunt (pulmonary flow [Qp] to systemic flow [Qs] ratio >1.5). Closure of an ASD is not recommended in patients with a clinically insignificant shunt (Qp-Qs ratio 0.7 or below) and in those who have severe pulmonary arterial hypertension or irreversible pulmonary vascular occlusive disease who have a reversed shunt : right to left with hypoxemia. We report the case of a men aged 35 years, admitted to the ICU for a left pneumo-hemothorax with rib fracture resulting from an accident of the highway, drained emergency. Auscultation of the heart sounds: a systolic ejection murmur, respiratory variations in the splitting of the second heart sound; in the ECG: presence of incomplete right bundle branch block with atrial flutter. The echocardiography at the bedside with multiple effects showed dilatation of the right ventricle, and confirming the atrial septal defect type ostium secundum with left-right shunt noting that the subcostal window is a better impact on the diagnostic to ask for two reasons: ultrasound are perpendicular, Doppler is strictly aligned . Hypertension of pulmonary artery measured at 45 mmHg. The patient is referred to the cardiovascular consultation after its release for therapeutic cardiology discussion.


Corresponding author:
Zine el abidine Benali, Department of Anesthesiology, CHP Eddarak, Berkane, Morocco
benazine1@yahoo.fr

©Zine el Abidine Benali et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

More images in clinical medicine

 
 
 
 
 
 
 
 
    






PAMJ Images in Medicine and Public Health are archived on Pubmed Central. Access PAMJ archives on PMC here

Volume 34 (September - December 2019)

This image


Share this image:

Filter images [Reset filter]

By language

PAMJ is published in collaboration with the African Field Epidemiology Network (AFENET)
Currently tracked by: DOAJ, AIM, Google Scholar, AJOL, EBSCO, Scopus, Embase, IC, HINARI, Global Health, PubMed Central, PubMed/Medline, Ulrichsweb, More to come . Member of COPE.

ISSN: 1937-8688. © 2019 - Pan African Medical Journal. All rights reserved