Atrial Septal Defect

Preliminary Diagnosis: Atrial Septal Defect

I. What imaging technique is first-line for this diagnosis

• 2-D Echocardiography

II. Describe the advantages and disadvantages of this technique for diagnosis.

Advantages

• Highly portable imaging modality.

• Does not expose patients to ionizing radiation.

• Highly sensitive and specific in detecting cardiac structural abnormalities and cardiac chamber pressures.

Disadvantages

• Limited in evaluating the surrounding soft tissues.

III. What are the contraindications for the first-line imaging technique?

• No specific contraindications to echocardiography exist

IV. What alternative imaging techniques are available?

• Plain Radiography of the Chest (PA and Lateral)

• Cardiac MR.

V. Describe the advantages and disadvantages of the alternative techniques for diagnosis.

Plain Radiography of the Chest (PA and Lateral)

Advantages

• Fast and portable imaging modality.

• Exposes patients to minimal ionizing radiation.

Disadvantages

• Less sensitive and specific in detailing the cardiomediastinal silhouette, pericardium, and cardiac chambers.

• Unable to evaluate the pressure measurements within the cardiac chambers and valvular structures.

Cardiac MR

Advantages

• Sensitive and specific in detecting the flow and directionality of blood throughout the cardiac chambers and surrounding great vessels

• Gold standard in evaluating cardiac structure including valvular and chamber architecture.

• Does not expose patients to ionizing radiation.

Disadvantages

• Expensive

• Time consuming

• Must be cardiac gated to eliminate cardiac motion artifact.

VI. What are the contraindications for the alternative imaging techniques?

Plain Radiography of the Chest (PA and Lateral)

• No specific contraindications to plain radiography exist. Some insitutions may require signed consent for pregnant women

Cardiac MR

• Contraindicated in patients with non MR compatible hardware.