Abstract
Context: Atrial septal defect may rarely be associated with other cardiac diseases such as arrhythmia, and may require additional intervention. Case report: A 16-year-old boy presented with effort dyspnea, tiredness, and fatigue. The electrocardiograph revealed right bundle branch block, atrioventricular block, and left axis deviation. Ostium secundum type of atrial septal defect was detected by transthoracic echocardiography and was confirmed by transesophageal echocardiography. The patient was advised to undergo percutaneous device closure. Permanent pacemaker implantation was also suggested considering the risk of fatal arrhythmias associated with atrioventricular block. Consequently, patient underwent percutaneous atrial septal defect closure and implantation of pacemaker in a single sitting. Both the procedures were successful, after which the patient showed remarkable symptomatic improvement. Conclusion: In atrial septal defect patients with unexplained atrioventricular block, closure of atrial septal defect and implantation of pacemaker in single sitting appear to be an attractive modality.
Highlights
Atrial septal defects (ASDs) are one of the most frequently diagnosed cardiovascular malformations in adults and adolescents
Genetic analyses have shown that mutations in NKX2.5 and GATA4 genes are responsible for familial forms of secundum ASD [1]
We report a case of asymptomatic ASD in a 16year-old boy who underwent percutaneous device closure and permanent pacemaker implantation in a single sitting
Summary
Atrial septal defects (ASDs) are one of the most frequently diagnosed cardiovascular malformations in adults and adolescents. It affects over one in 1500 live births and accounts for nearly 10% of congenital heart defects. Ostium secundum is the most common type of atrial septal defect, accounting for about 85% of all ASDs [1]. It is reported that about 90% of patients with ASD die by the age 60. Patients with atrial septal defect, even those who are asymptomatic, are recommended to undergo the correction of the anomaly [2]. We report a case of asymptomatic ASD in a 16year-old boy who underwent percutaneous device closure and permanent pacemaker implantation in a single sitting
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