Ostium secundum type 75%
Commonest. It is due to defective formation of seotum secundum.
Ostium primum type (20%)
Rare. This is due to defective formation of septum primum and is associated with cushion defect.
Sinus venosus type (5%).
Due to pressure gradient and more compliance the existent defect in the atrial septum will cause shunting of blood from left to right atrium and then to the right ventricle and pulmonary trunk causing hypertrophy and dilation of the structures.
In course of the due to increased pressure on the right side of the heart reversal of the shunt may rarely take place (Eisenmeneger’s syndrome).
Sometime mitral stenosis may be associated with ASD which is called lutembacher’s syndrome and skeletal deformity called Holt-Oram syndrome.
Symptoms when present include dyspnoea, palpitation , rarely cardiac failure,fatigue. Left atrialization of jugular venous pressure (I. e. a wave =V wave)
When cyanosis appears it indicates shunt reversal.
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