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.
- Family history
- Other congenital heart defects
- Thalidomide, alcohol
- 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.