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Atrial Septal Defect

Atrial Septal Defect

This is an auscultation example of an atrial septal defect as heard at the pulmonic position. Atrial Septal Defect is a congenital condition associated with abnormal blood flow between the left atrium and the right atrium. Before birth there is a large connection between right and left atria. During development of the fetus the connection gradually disappears. However, in some cases the opening persists and is known as an atrial septal defect. Both the first and second heart sounds are split. The second heart sound splitting is fixed at 80 milliseconds. There is a brief diamond shaped murmur in early systole and another brief diamond shaped murmur in early diastole In the anatomy video you see an enlarged right atrium and right ventricle. You see turbulent blood flow across the tricuspid valve between the right atrium and the right ventricle (the diastolic murmur). This is caused by blood flow from the left atrium into the right atrium through the atrial septal defect. There is further turbulent flow into the pulmonary artery causing the systolic murmur.


Auscultation Sounds

auscultation sound from lesson
waveform


Patient Recording

patient heart or lung sound
Atrial Septal Defect


Patient Recording - Half Speed Playback

patient heart or lung sound
Atrial Septal Defect



Position

Patient position
The patient's position should be supine.

Listening Tips

S1:Split
Systole:Diamond shaped, brief, early murmur
S2:Fixed splitting
Diastole:Diamond shaped, brief, early murmur


Waveform (Phonocardiogram)

Observe

//embedding heart animation
Play the cardiac animation and look for an enlarged right atrium and right ventricle.

Authors

These authors contributed the audio recordings and text found in this reference guide: Jon Keroes, MD,Diane Wrigley, PA, and David Lieberman.
Medically reviewed by Dr. Barbara Erickson, PhD, RN, CCRN.



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