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Old 05-22-2011
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Heart Atrial Septal Defect found at autopsy

Got a question in Kaplan Qbook:
Anatomy, test one, #36.

Autopsy of man who died of an unknown case, the pathologist discovered small ASD, near upper border of fossa ovalis. Which one was likely functional manifestation of this defect during life?

a) no cyanosis pre or postnatally
b) postnatal cyanosis due to left to right shunt
c) postnatal cyanosis due to right to left shunt
d) prenatal cyanosis due to right to left shunt
e) prenatal cyanosis due to left to right shunt

Got it wrong, what is your options.

Thank you.
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Old 05-22-2011
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Default C

I would go with C) postnatal cyanosis due to right to left shunt
Is that the right answer ?
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Old 05-22-2011
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I would go with a) no cyanosis pre or postnatally
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Old 05-22-2011
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Quote:
Originally Posted by bebix View Post
I would go with a) no cyanosis pre or postnatally
please explain
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Old 05-22-2011
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Default No cyanosis pre or post natally..

The pressure in the left atrium is always greater than the right so there would be only one way of shunting from left to right..so there wudnt be a cyanosis..
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Old 05-22-2011
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Quote:
Originally Posted by jahn77 View Post
please explain
cyanosis => youŽll need a right to left shunt

most of the time the ASD is an acyanotic lesion. Thus, the patient should be normally saturated. In the rare case of severe pulmonary arterial hypertension, atrial shunt reversal (Eisenmenger syndrome) may occur, leading to cyanosis = this is rare with a small ASD.
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Old 05-22-2011
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a) no cyanosis pre or postnatally
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Old 05-22-2011
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It's definitely A....and the explanation already mentioned above
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Old 05-22-2011
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answer is A


explanation :

postnatal : for cynosis we need right to left shunt. and in ASD the shunt is left to right as pressure in lt atrium is morethan right atrium ..

prenatally : the shunt is always from rt to lt but it doesnt cause any cynosis as the blood in rt side is more oxygenated than left side .,..


am i correct .. ? please edit me if i am wrong ...
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Old 05-22-2011
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Default answer

Answer is A;no cyanosis,

I was wrong with this qn b-se in general ASD is considered late cyanotic defect (blue kids) with PDA and VSD due to left to right shunt.
Probably clue here is small size of defect?

Thanks to everyone.
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