SYM = SYMptomatic ASD = Dyspnea on exertion, fatigue, palpitations, evidence of atrial arrhythmias, orthodeoxia-platypnea.
ASYM = ASYMptomatic ASD (small shunt and normal RV size).
SIG-SHUNT = Significant left-to-right shunt (usually caught on echo), Qp:Qs >1.5.
STR-CHANGE = Evidence of STRuctural CHANGEs in the heart such as elevated pulmonary pressure, right atrial or right ventricular enlargement or hypertrophy.
PxE = History of a paradoxical embolic event.
CLOSURE = CLOSURE of ASD. Can be performed percutaneously or surgically depending on size and location of ASD.
FOLLOW = Clinical follow-up and echocardiogram every 2–3 years or sooner if symptoms develop.
END-STAGE = The clinical picture from an uncorrected significant ASD over time. May have severe irreversible pulmonary hypertension or Eisenmenger physiology. Mortality is not improved with closure at this point. Prognosis is poor (pulmonary artery pressure >2/3 systemic pressure, pulmonary vascular resistance >2/3 systemic vascular resistance).
MED-TX = Medical management. There is no medicine to correct the anatomical defect. Can give medicines to alleviate right heart failure and pulmonary hypertension.
PE = Paradoxical Embolism.
OP = Orthodeoxia Platypnea.
PAP < 2/3 SBP = Pulmonary artery pressure less than two thirds systemic levels.
PVR < 2/3 SVR = Pulmonary vascular resistance less than two thirds systemic vascular resistance.