Clinical characteristics of adult uncorrected secundum atrial septal defect: a pilot study
ABSTRACT: Atrial septal defect
(ASD) is the most frequent congenital heart disease in adulthood. Pulmonary
hypertension (PH) complicating ASD compels patients seeking medical assistance
because of its disabling symptom. Most adult ASD develop PH which render signifcant
morbidity and mortality. The aim of the study is to characterize the clinical profles
of adult patients with ASD. The study design was cross sectional. The subjects were
enrolled consecutively from outpatient clinics and inpatient wards. The
demography, medical and imaging data were collected and recorded in case report
form. Descriptive statistics was applied to characterize the subjects.
Seventy-six subjects were enrolled.The majority were women (77.6 %) in the
productive and child-bearing ages (63.2%). The most common symptoms were
dyspneu on effort, fatigue, and palpitation. Most subjects had functional
capacity of WHO class functional II (70.2 %). The mean oxygen saturation was
96.4 %. Based on the echocardiography examination, 77.6% of subjects had
suffered from PH. The mean longest diameter of defects were 2.7 cm. The
directionof blood flow was mostly left to right (77.6 %). Left and right
ventricle function were within normal limit. Right heart catheterization showed
mean left atrial pressure 11.5 mmHg, which confrmed the precapillary or
arterial PH. Mean pulmonary artery pressure was 42.0 mmHg. The pulmonary artery
resistance index mostly less than 4 Wood Unit/ m2 (63.7 %), indicating the
feasibility to close the defect. Whereas 24.6 % of subjects were
contraindicated for closing. Pulmonary artery hypertension (PAH) was diagnosed
in 7.6 % subjects, meanwhile 13.2 % had
borderline PAH. In conclusion, most adult ASD patients had developed PAH,
mostly young women in productive ages, mainly visited hospital due to symptom
of PH, the direction of flow predominantly left to right side and mostly had
reduced functional capacity.
Keywords: atrial septal defect
- pulmonal hypertension - pulmonary artery hypertension – echocardiography –
symptoms
Author: Lucia Krisdinarti,
Anggoro Budi Hartopo, Dyah Wulan Anggrahini, Ahmad Hamim Sadewa, Abdus Samik
Wahab, Budi Yuli Setianto
Journal Code: jpkedokterangg160173
