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.


Ostium Primum ASD (Inter atrial communica­tion)

Risk Factorsfor Ostium Primum ASD

  • 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.

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