Adult Echocardiography Practice Exam

What is a common consequence of untreated atrial septal defects?

1. Left ventricular dilation

2. Pulmonary congestion

3. Right ventricular hypertrophy

4. Cor pulmonale

The correct answer is: Right ventricular hypertrophy

In the context of untreated atrial septal defects (ASDs), right ventricular hypertrophy is a common consequence due to the abnormal volume overload in the right heart chambers. An ASD allows for excessive blood flow from the left atrium to the right atrium, leading to increased blood flow into the right ventricle. Over time, the right ventricle is subjected to this higher volume load, causing it to adapt by undergoing hypertrophy – a process where the muscle fibers enlarge to accommodate the increased workload. As a result of this condition, the right ventricle’s walls thicken, and the overall function can be compromised if left untreated. Patients may eventually experience symptoms related to right heart failure or other complications due to the progressive changes in the heart structure. In contrast, left ventricular dilation typically occurs because of different mechanisms, such as coronary artery disease or pressure overload, rather than directly from an ASD. While pulmonary congestion may be seen in other contexts, specifically in the case of significant left-sided heart failure, it is not a direct consequence tied specifically to ASDs. Lastly, cor pulmonale, which refers to right heart failure secondary to lung disease, would not be a direct or immediate consequence of ASD alone. Thus, right ventricular hypertrophy