Ostium Primum ASD (Inter atrial communica­tion)

• The opening in the first septum of the embryonic heart; it closes as the ventricles form.
• There is right to left shunt and mitral valve regurgita­tion.
• Symptoms occur in childhood itself with congestive heart failure and retarded growth and development.
• There is atrial fibrillation commonly.
• Due to mitral regurgitation, patients are prone to in­fective endocarditis.
• There is murmur of MR radiating to left sternal edge.
• There is pulmonary mid-systolic ejection murmur and wide fixed splitting of second heart sound.
• 15%: Ostium primum occurs in the inferior portion of the septum, often associated with cleft mitral valve and failure of endocardial cushing
• JVP shows dominant v wave due to the jet from left ventricle to right atrium.•
• There is left ventricular apical impulse with thrill.

Risk Factorsfor Ostium Primum ASD

• Family history
• Other congenital heart defects
• Thalidomide, alcohol

ECG –

• shows RSR pattern in V1, V2, RAD with LVH, also expects LAD with LVH

2D echocardiography and Doppler: shows the defects.

• Colour flow shows the left to right interatrial shunt and mitral regurgitation.