Wow, awesome. How are you now?

@Paul Ibukunoluwa Good as l could be. Every day is a little different. I felt normal until l was in my late 20s, and then everything started happening so gradually l barely noticed how frequently l was out of breath. Since the surgery, it's significantly improved and long walks and stairs don't bother me as much

@@thecavman that's good to hear

I'm sorry to ask, and sorry for my english but how so young are you during the first surgery?

@TabordaEl My first surgery I was 5. My second I was 9, where they did a cardiac catheter with a balloon procedure. That worked well until I was in my late 20s. That's when the valves weren't doing the job anymore.

Glad you enjoyed it!

😊

thanks

Or the direction depends on how much pressure is in the atria?

Yes it should be left to right shunt

@@gianchiong7882 No, the shunt is in fact coming from the high pressure to the low pressure. In this anomaly, the RA is enlarged, full of blood, unable to pump it through the small right ventricle, leading to some kind of congestion and pathological increase in its pressure. As a result, the ASD will allow blood to go from the high pressure (RA) to the left atrium (LA). In fact, most of the ASDs will cause left to right shunt, in the beginning (due to the high pressure of the left chambers of the heart, compared to the right chambers), however, due to the increased blood flow through the ASD --> ↑ pulmonary blood flow --> with time --> pulmonary hypertension --> the shunt direction will be reversed (eisenmenger's phenomenon). In this case, it starts as a right to left shunt, simply due to the "hypertension" in the RA, compared to the LA; and there's no reversal of the shunt.

​@@eliasdallysuper welldone, this is perfect

This was a great explanation @@eliasdallysuper

Thanks

@@ZeroToFinals Just finished and passed my FRCEM finals Tom. I found your videos and explanations really helpful for a quick refresher of concepts . I can personally relate to the diligent vs cramming student video you did ..I had long been a victim of that trap...Reading endless hours but not consolidating..I would argue that overall it has made me a better clinician ...but exams are a different ball game and we need to do focused reading .. Keep up the great work

@@gift4636 Congratulations on your FRCEM!

ASD is acyanotic usually(left to rt shunt), but here since there is rt atrial enlargement and higher pressure there is rt to lft shunting , hence cyanosis... Thts wt i think

@@reshmas7588 Thanks for your explanation, it's very helpful.

​@@reshmas7588 yeah good explanation. Was trying to work out why the shunt was in the opposite direction. This helps a lot.

Thank you!

If u dont mind can we talk about this situation cause I have this too and i want to talk to someone

@@catmeow2463 yea

How did you cope with Ebsteins anomal ? Did you do a surgery? If you don’t mind to share .

Can we talk? I do have some concerns