ASD question on QBank

[BlackNDecker]

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Anyone else gotten this question:

Man is diagnosed with an ASD. What is the MCC of such a congenital heart malformation?

Relevant choices were:
A. Fx of formation of septum primum
B. Fx of formation of septum secundum
C. Incomplete adhesion b/w septum primum and septum secundum
(D & E described VSD)

Kaplan says the answer is C. Is this not the description of a patent foramen ovale? PFO is not an ASD. In Lily's Pathophys. of Heart Dz, the defect in ASD is described to arise from excessive resorption or inadequate development of the septum primum, inadequate formation of the septum secundum, or a combination of both.

Any thoughts?

 

[Idiopathic]

PFO is not an ASD.

Not true. PFO is an example of ASD, and in fact the most common type of ASD, often undiagnosed. This is why C is correct.

 

[BlackNDecker]

Not true. PFO is an example of ASD, and in fact the most common type of ASD, often undiagnosed. This is why C is correct.

According to Pathopys. of Heart Dz, PFO is NOT a true ASD...oddly, Kaplan uses the same arguement("PFO should not be confused with ASD") in defending the above answer 🙄

I think that it might not be considered a true defect due to the prevalence. Continuing this reasoning, left handedness might be considered a defect if it was much, much less common

 

[nrosigh]

I think that a PFO may not be considered a defect because they are usually hemodynamically inconsequential (until, of course, someone strokes out because of it). "No murmur, no problem" type of thing.

ASD's usually do have some L to R shunting.

But anyway, I remember getting that QBank one wrong too (I also chose B).

QBank is such a mixed bag sometimes. There really is such esoteric garbage in there, but on the other hand it can be really useful to pinpoint your weaknesses. I've taken 3 NBME assessments so far and I don't remember any trivia or irritating semantics on those....

According to Pathopys. of Heart Dz, PFO is NOT a true ASD...oddly, Kaplan uses the same arguement("PFO should not be confused with ASD") in defending the above answer 🙄

I think that it might not be considered a true defect due to the prevalence. Continuing this reasoning, left handedness might be considered a defect if it was much, much less common

 

[BlackNDecker]

I've taken 3 NBME assessments so far and I don't remember any trivia or irritating semantics on those....

Good point 👍

 

[Idiopathic]

Just think about it logically. A PFO is a defect in the atrial septum, and is therefore an atrial septal defect.

Actually, a PFO can have significant shunting, but you are right, most are asymptomatic. However, they account for the majority of defects in the atrial septa

 

[BlackNDecker]

Just think about it logically. A PFO is a defect in the atrial septum, and is therefore an atrial septal defect.

Actually, a PFO can have significant shunting, but you are right, most are asymptomatic. However, they account for the majority of defects in the atrial septa

I'm still not convinced because Lilly is pretty specific on this point...as is Kaplan.

Kaplans rationale:
"The most common form of ASD arises near the foramen ovale, not to be confused with a patent foramen ovale which is of little hemodynamic significance. They result from incomplete adhesion of the septum primum and septum secundum.

ASD's less commonly result from failure of formation of septum primum and septum secundum."

Sorry Kaplan...please don't revoke my subsctiption 😀

 

[Idiopathic]

I'm still not convinced because Lilly is pretty specific on this point...as is Kaplan.

okay, well either way. I think the term 'ASD' is WAY too general to not include PFO. But definitely the case for the above question.

edit: hmm you changed your post apparently....right before i quoted it.

 

[BlackNDecker]

okay, well either way. I think the term 'ASD' is WAY too general to not include PFO. But definitely the case for the above question.

edit: hmm you changed your post apparently....right before i quoted it.

Yeah, sorry...I changed it once again to include Kaplan's rationale...

 

[Idiopathic]

well even that doesnt help much. Ill just always think of the most common congenital defect in the atrial septum as being the PFO. HOWEVER, I understand (now more than ever) that the boards want different things.

 

[SaltySqueegee]

I've lost about 1,000 brain cells after reading this forum post... ... ugh.

 

[Tamara01]

How true it is that antidepressants and statin can lead to child's heart malformation? I've read about it on a lot of sites. Do you have some kind of study about that?

 

[username456789]

How true it is that antidepressants and statin can lead to child's heart malformation? I've read about it on a lot of sites. Do you have some kind of study about that?

I can tell you what it doesn't cause: a "fracture" of any part of the heart.

(Also this is a really old thread).

 

[MilkmanAl]

Unbreak my heeeeart. Say you'll love me agaaaaaiiiiin...

 

[kryptik]

page 173, Rapid Review Pathology 3rd Edition

c. Atrial septal defect (ASD)
1 Patent foramen ovale (secundum type; most common type)
a. Accounts for 10% to 15% of cases of all CHD
b. Most common adult CHD

 

[turkeyjerky]

page 173, Rapid Review Pathology 3rd Edition

c. Atrial septal defect (ASD)
1 Patent foramen ovale (secundum type; most common type)
a. Accounts for 10% to 15% of cases of all CHD
b. Most common adult CHD

yeah, but most authors don't consider a pfo to be congenital heart disease. same as a bicuspid aortic valve isn't chd. it's a semantic thing. plus, a pfo won't have the same findings as an asd (fixed wide splitting, etc)