ACC AHA recommendations for evaluation of the unoperated patient in atrial septal defect


 * Associate Editors-In-Chief: Priyamvada Singh, MBBS mailto:psingh@perfuse.org; ; Assistant Editor-In-Chief: Kristin Feeney, B.S. mailto:kfeeney@perfuse.org

Overview
ACC/AHA recommends for different diagnostic tools that could be used to evaluate a patient of atrial septal defect ==ACC/AHA recommendations for evaluation of the unoperated patient with atrial septal defect (DONOT EDIT)==

Class I

1. Atrial septal defect (ASD) should be diagnosed by imaging techniques with demonstration of shunting across the defect and evidence of right ventricular (RV) volume overload and any associated anomalies. (Level of Evidence: C)

2. Patients with unexplained RV volume overload should be referred to an adult congenital heart disease (ACHD) center for further diagnostic studies to rule out obscure ASD, partial anomalous venous connection, or coronary sinoseptal defect. (Level of Evidence: C)

Class IIa

1. Maximal exercise testing can be useful to document exercise capacity in patients with symptoms that are discrepant with clinical findings or to document changes in oxygen saturation in patients with mild or moderate pulmonary arterial hypertension (PAH). (Level of Evidence: C)

2. Cardiac catheterization can be useful to rule out concomitant coronary artery disease in patients at risk because of age or other factors. (Level of Evidence: B)

Class III

1. In younger patients with uncomplicated ASD for whom imaging results are adequate, diagnostic cardiac catheterization is not indicated. (Level of Evidence: B)

2. Maximal exercise testing is not recommended in ASD with severe PAH. (Level of Evidence: B)

For ACC/AHA Level of evidence and classes click:ACC AHA Guidelines Classification Scheme