Authors :
Zulkifli Bachmid; Andi Alief Utama Armyn; Yulius Patimang; Muzakkir Amir
Volume/Issue :
Volume 9 - 2024, Issue 4 - April
Google Scholar :
https://tinyurl.com/m2u6ah9x
Scribd :
https://tinyurl.com/5n8893r9
DOI :
https://doi.org/10.38124/ijisrt/IJISRT24APR376
Abstract :
Background:
ASD occurs when there is a septal defect between the
right and left atria, resulting in a left-to-right shunt that
increases the volume of the right heart and pulmonary
circulation. Increased pulmonary resistance can lead to
pulmonary hypertension (PH), resulting in progressive
deterioration of right ventricular function, leading to
right heart failure and death. Prolonged elevation of
atrial pressure induces progressive atrial dilatation and
electrophysiological remodelling. Together with
autonomic modulation, this leads to atrial arrhythmias
(AAs). Patients with significant shunts leading to
ventricular volume overload are considered for ASD
closure. However, in some cases, PH occurs after ASD
closure.
Case Presentation:
We report a 21 yo man diagnosed with ASD
Secundum Post Closure with Device (September 1th,
2023) and Pulmonary Hypertension Crisis. The left atria
(LA), right atria (RA) and right ventricle (RV) were
dilated. We also found moderate mitral regurgitation,
severe tricuspid regurgitation, and mild to moderate
pulmonary regurgitation. There was a decline in systolic
function in the right ventricle, and grade III diastolic
dysfunction in left ventricle. There was a well-seated
device with no residual shunt on interatrial septal. The
pulmonary arteries were confluence and dilated. From
ECG we found atrial flutter with variable conduction.
This patient was transferred to HCU. This patient treated
with digoxin, furosemide, milrinon, ceftriaxone, miniaspi,
sildenafil, electrophysiology, and 3D ablation.
Conclusion:
Pulmonary hypertension can occur in cases of
congenital heart defects, such as ASD. The operative
management of ASD is closure of the ASD, but in some
unique groups, this can lead to pulmonary hypertensive
crisis after its closure.
Keywords :
ASD (Atrial Septal Defect); ASD Secundum Post Closure; Pulmonary Hypertension Crisis; Right Heart Failure.
Background:
ASD occurs when there is a septal defect between the
right and left atria, resulting in a left-to-right shunt that
increases the volume of the right heart and pulmonary
circulation. Increased pulmonary resistance can lead to
pulmonary hypertension (PH), resulting in progressive
deterioration of right ventricular function, leading to
right heart failure and death. Prolonged elevation of
atrial pressure induces progressive atrial dilatation and
electrophysiological remodelling. Together with
autonomic modulation, this leads to atrial arrhythmias
(AAs). Patients with significant shunts leading to
ventricular volume overload are considered for ASD
closure. However, in some cases, PH occurs after ASD
closure.
Case Presentation:
We report a 21 yo man diagnosed with ASD
Secundum Post Closure with Device (September 1th,
2023) and Pulmonary Hypertension Crisis. The left atria
(LA), right atria (RA) and right ventricle (RV) were
dilated. We also found moderate mitral regurgitation,
severe tricuspid regurgitation, and mild to moderate
pulmonary regurgitation. There was a decline in systolic
function in the right ventricle, and grade III diastolic
dysfunction in left ventricle. There was a well-seated
device with no residual shunt on interatrial septal. The
pulmonary arteries were confluence and dilated. From
ECG we found atrial flutter with variable conduction.
This patient was transferred to HCU. This patient treated
with digoxin, furosemide, milrinon, ceftriaxone, miniaspi,
sildenafil, electrophysiology, and 3D ablation.
Conclusion:
Pulmonary hypertension can occur in cases of
congenital heart defects, such as ASD. The operative
management of ASD is closure of the ASD, but in some
unique groups, this can lead to pulmonary hypertensive
crisis after its closure.
Keywords :
ASD (Atrial Septal Defect); ASD Secundum Post Closure; Pulmonary Hypertension Crisis; Right Heart Failure.
