An atrial septal defect (ASD) causes a left to right shunt, which enlarges the right atrium. Because of this effect, which of the following conditions often occur with ASD?
A. Asthma
B. Jugular venous distension
C. Atrial fibrillation
D. B & C
ANS: D
ASD is a congenital abnormality in which oxygenated blood is shunted from a higher-pressured left atrium to a lower-pressured right atrium through an abnormal opening in the atrial septum. Atrial arrhythmias, especially atrial fibrillation, are common in the adult population with ASD. ASDs are often accompanied by other congenital heart defects, but in an uncomplicated lesion, patients are often asymptomatic until early adulthood, when they present with dyspnea on exertion or palpitations resulting from atrial arrhythmia. Because patients may be asymptomatic for many years, right HF can be the first sign, and patients may present with jugular venous distension, edema, and ascites.
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