home
***
CD-ROM
|
disk
|
FTP
|
other
***
search
/
Gold Medal Software 3
/
Gold Medal Software - Volume 3 (Gold Medal) (1994).iso
/
tutor
/
cardbk10.arj
/
ATSEPT1.CAR
< prev
next >
Wrap
Text File
|
1994-01-21
|
25KB
|
1,524 lines
m18
RF0 0 639 479
XxA
XxZ
T1
O12
XxA
XxZ
T1
XxA
L319 1 319 2
L319 2 320 2
L320 2 321 2
L321 2 322 2
L322 2 323 2
L323 2 324 2
L324 2 325 2
L325 2 326 2
L326 2 327 2
L327 2 328 2
L328 2 329 2
L329 2 330 2
L330 2 331 2
L331 2 332 2
L332 2 333 2
L333 2 334 2
L334 2 335 2
L335 2 336 2
L336 2 337 2
L337 2 338 2
L338 2 339 2
L339 2 340 2
L340 2 341 2
L341 2 342 2
L342 2 343 2
L343 2 344 2
L344 2 345 2
L345 2 346 2
L346 2 347 2
L347 2 348 2
L348 2 349 2
L349 2 350 2
L350 2 351 2
L351 2 352 2
L352 2 353 2
L353 2 354 2
L354 2 355 2
L355 2 356 2
L356 2 357 2
L357 2 358 2
L358 2 359 2
L359 2 360 2
L360 2 361 2
L361 2 362 2
L362 2 363 2
L363 2 364 2
L364 2 365 2
L365 2 366 2
L366 2 367 2
L367 2 368 2
L368 2 369 2
L369 2 370 2
L370 2 371 2
L371 2 372 2
L372 2 373 2
L373 2 374 2
L374 2 375 2
L375 2 376 2
L376 2 377 2
L377 2 378 2
L378 2 379 2
L379 2 380 2
L380 2 381 2
L381 2 382 2
L382 2 383 2
L383 2 384 2
L384 2 385 2
L385 2 386 2
L386 2 387 2
L387 2 388 2
L388 2 389 2
L389 2 390 2
L390 2 391 2
L391 2 392 2
L392 2 393 2
L393 2 394 2
L394 2 395 2
L395 2 396 2
L396 2 397 2
L397 2 398 2
L398 2 399 2
L399 2 400 2
L400 2 401 2
L401 2 402 2
L402 2 403 2
L403 2 404 2
L404 2 405 2
L405 2 406 2
L406 2 407 2
L407 2 408 2
L408 2 409 2
L409 2 410 2
L410 2 411 2
L411 2 412 2
L412 2 413 2
L413 2 414 2
L414 2 415 2
L415 2 416 2
L416 2 417 2
L417 2 418 2
L418 2 419 2
L419 2 420 2
L420 2 421 2
L421 2 422 2
L422 2 423 2
L423 2 424 2
L424 2 436 2
L436 2 448 2
L448 2 460 2
L460 2 472 2
L472 2 484 2
L484 2 496 2
L496 2 508 2
L508 2 520 2
L520 2 532 2
L532 2 544 2
L544 2 556 2
L556 2 568 2
L568 2 580 2
L580 2 592 2
L592 2 604 2
L604 2 616 2
L616 2 628 2
L628 2 629 2
L629 2 630 2
L630 2 631 2
L631 2 632 2
L632 2 633 2
L633 2 634 2
L634 2 635 2
L635 2 636 2
L636 2 637 2
L637 2 637 3
L637 3 637 4
L637 4 637 5
L637 5 637 6
L637 6 637 7
L637 7 637 8
L637 8 637 9
L637 9 637 10
L637 10 637 11
L637 11 637 12
L637 12 637 13
L637 13 637 14
L637 14 637 15
L637 15 637 16
L637 16 637 17
L637 17 637 18
L637 18 637 19
L637 19 637 20
L637 20 637 21
L637 21 637 22
L637 22 637 23
L637 23 637 24
L637 24 637 25
L637 25 637 26
L637 26 637 27
L637 27 637 28
L637 28 637 29
L637 29 637 30
L637 30 637 31
L637 31 637 32
L637 32 637 33
L637 33 637 34
L637 34 637 35
L637 35 637 36
L637 36 637 37
L637 37 637 38
L637 38 637 39
L637 39 637 40
L637 40 637 41
L637 41 637 42
L637 42 637 43
L637 43 637 44
L637 44 637 45
L637 45 637 46
L637 46 637 47
L637 47 637 48
L637 48 637 49
L637 49 637 50
L637 50 637 51
L637 51 637 52
L637 52 637 53
L637 53 637 54
L637 54 637 55
L637 55 637 56
L637 56 637 57
L637 57 637 58
L637 58 637 59
L637 59 637 60
L637 60 637 61
L637 61 637 62
L637 62 637 63
L637 63 637 64
L637 64 637 65
L637 65 637 66
L637 66 637 67
L637 67 637 68
L637 68 637 69
L637 69 637 70
L637 70 637 71
L637 71 637 72
L637 72 637 73
L637 73 637 74
L637 74 637 75
L637 75 637 76
L637 76 637 77
L637 77 637 78
L637 78 637 79
L637 79 637 80
L637 80 637 81
L637 81 637 82
L637 82 637 83
L637 83 637 84
L637 84 637 85
L637 85 637 86
L637 86 637 87
L637 87 637 88
L637 88 637 89
L637 89 637 90
L637 90 637 91
L637 91 637 92
L637 92 637 93
L637 93 637 94
L637 94 637 95
L637 95 637 96
L637 96 637 97
L637 97 637 98
L637 98 637 99
L637 99 637 100
L637 100 637 101
L637 101 637 102
L637 102 637 103
L637 103 637 104
L637 104 637 105
L637 105 637 106
L637 106 637 107
L637 107 637 108
L637 108 637 109
L637 109 637 110
L637 110 637 111
L637 111 637 112
L637 112 637 113
L637 113 637 121
L637 121 637 129
L637 129 637 137
L637 137 637 145
L637 145 637 153
L637 153 637 161
L637 161 637 169
L637 169 637 177
L637 177 637 185
L637 185 637 193
L637 193 637 201
L637 201 637 209
L637 209 637 217
L637 217 637 225
L637 225 637 233
L637 233 637 241
L637 241 637 249
L637 249 637 257
L637 257 637 265
L637 265 637 273
L637 273 637 281
L637 281 637 289
L637 289 637 297
L637 297 637 305
L637 305 637 313
L637 313 637 321
L637 321 637 329
L637 329 637 337
L637 337 637 345
L637 345 637 353
L637 353 637 361
L637 361 637 369
L637 369 637 377
L637 377 637 385
L637 385 637 393
L637 393 637 401
L637 401 637 409
L637 409 637 417
L637 417 637 425
L637 425 637 433
L637 433 637 441
L637 441 637 449
L637 449 637 457
L637 457 637 465
L637 465 637 473
L637 473 637 474
L637 474 637 475
L637 475 637 476
L637 476 637 477
L637 477 636 477
L636 477 635 477
L635 477 634 477
L634 477 633 477
L633 477 632 477
L632 477 631 477
L631 477 630 477
L630 477 629 477
L629 477 628 477
L628 477 627 477
L627 477 626 477
L626 477 625 477
L625 477 624 477
L624 477 623 477
L623 477 622 477
L622 477 621 477
L621 477 620 477
L620 477 619 477
L619 477 618 477
L618 477 617 477
L617 477 616 477
L616 477 615 477
L615 477 614 477
L614 477 613 477
L613 477 612 477
L612 477 611 477
L611 477 610 477
L610 477 609 477
L609 477 608 477
L608 477 607 477
L607 477 606 477
L606 477 605 477
L605 477 604 477
L604 477 603 477
L603 477 602 477
L602 477 601 477
L601 477 600 477
L600 477 599 477
L599 477 598 477
L598 477 597 477
L597 477 596 477
L596 477 595 477
L595 477 594 477
L594 477 593 477
L593 477 581 477
L581 477 569 477
L569 477 557 477
L557 477 545 477
L545 477 533 477
L533 477 521 477
L521 477 509 477
L509 477 497 477
L497 477 485 477
L485 477 473 477
L473 477 461 477
L461 477 449 477
L449 477 437 477
L437 477 425 477
L425 477 413 477
L413 477 401 477
L401 477 389 477
L389 477 377 477
L377 477 365 477
L365 477 353 477
L353 477 341 477
L341 477 329 477
L329 477 317 477
L317 477 305 477
L305 477 293 477
L293 477 281 477
L281 477 269 477
L269 477 257 477
L257 477 245 477
L245 477 233 477
L233 477 221 477
L221 477 209 477
L209 477 197 477
L197 477 185 477
L185 477 173 477
L173 477 161 477
L161 477 149 477
L149 477 137 477
L137 477 125 477
L125 477 113 477
L113 477 101 477
L101 477 89 477
L89 477 77 477
L77 477 65 477
L65 477 53 477
L53 477 41 477
L41 477 29 477
L29 477 17 477
L17 477 16 477
L16 477 15 477
L15 477 14 477
L14 477 13 477
L13 477 12 477
L12 477 11 477
L11 477 10 477
L10 477 9 477
L9 477 8 477
L8 477 7 477
L7 477 6 477
L6 477 5 477
L5 477 4 477
L4 477 3 477
L3 477 2 477
L2 477 1 477
L1 477 1 476
L1 476 1 475
L1 475 1 474
L1 474 1 473
L1 473 1 472
L1 472 1 471
L1 471 1 470
L1 470 1 469
L1 469 1 468
L1 468 1 467
L1 467 1 466
L1 466 1 465
L1 465 1 464
L1 464 1 463
L1 463 1 462
L1 462 1 461
L1 461 1 460
L1 460 1 459
L1 459 1 458
L1 458 1 457
L1 457 1 456
L1 456 1 455
L1 455 1 454
L1 454 1 453
L1 453 1 452
L1 452 1 451
L1 451 1 450
L1 450 1 449
L1 449 1 448
L1 448 1 447
L1 447 1 446
L1 446 1 445
L1 445 1 444
L1 444 1 443
L1 443 1 442
L1 442 1 441
L1 441 1 440
L1 440 1 439
L1 439 1 438
L1 438 1 437
L1 437 1 436
L1 436 1 435
L1 435 1 434
L1 434 1 433
L1 433 1 432
L1 432 1 431
L1 431 1 430
L1 430 1 429
L1 429 1 428
L1 428 1 427
L1 427 1 426
L1 426 1 425
L1 425 1 424
L1 424 1 423
L1 423 1 422
L1 422 1 421
L1 421 1 420
L1 420 1 419
L1 419 1 418
L1 418 1 417
L1 417 1 416
L1 416 1 415
L1 415 1 414
L1 414 1 413
L1 413 1 412
L1 412 1 411
L1 411 1 410
L1 410 1 409
L1 409 1 408
L1 408 1 407
L1 407 1 406
L1 406 1 405
L1 405 1 404
L1 404 1 403
L1 403 1 402
L1 402 1 401
L1 401 1 400
L1 400 1 399
L1 399 1 398
L1 398 1 397
L1 397 1 396
L1 396 1 395
L1 395 1 394
L1 394 1 393
L1 393 1 392
L1 392 1 391
L1 391 1 390
L1 390 1 389
L1 389 1 388
L1 388 1 387
L1 387 1 386
L1 386 1 385
L1 385 1 384
L1 384 1 383
L1 383 1 382
L1 382 1 381
L1 381 1 380
L1 380 1 379
L1 379 1 378
L1 378 1 377
L1 377 1 376
L1 376 1 375
L1 375 1 374
L1 374 1 373
L1 373 1 372
L1 372 1 371
L1 371 1 370
L1 370 1 369
L1 369 1 368
L1 368 1 367
L1 367 1 366
L1 366 1 365
L1 365 1 364
L1 364 1 363
L1 363 1 362
L1 362 1 361
L1 361 1 360
L1 360 1 359
L1 359 1 358
L1 358 1 357
L1 357 1 356
L1 356 1 355
L1 355 1 354
L1 354 1 353
L1 353 1 352
L1 352 1 351
L1 351 1 350
L1 350 1 349
L1 349 1 348
L1 348 1 347
L1 347 1 346
L1 346 1 345
L1 345 1 344
L1 344 1 343
L1 343 1 342
L1 342 1 341
L1 341 1 340
L1 340 1 339
L1 339 1 338
L1 338 1 337
L1 337 1 336
L1 336 1 335
L1 335 1 334
L1 334 1 333
L1 333 1 332
L1 332 1 331
L1 331 1 330
L1 330 1 329
L1 329 1 328
L1 328 1 327
L1 327 1 326
L1 326 1 325
L1 325 1 324
L1 324 1 323
L1 323 1 322
L1 322 1 321
L1 321 1 320
L1 320 1 312
L1 312 1 304
L1 304 1 296
L1 296 1 288
L1 288 1 280
L1 280 1 272
L1 272 1 264
L1 264 1 256
L1 256 1 248
L1 248 1 240
L1 240 1 232
L1 232 1 224
L1 224 1 216
L1 216 1 208
L1 208 1 200
L1 200 1 192
L1 192 1 184
L1 184 1 176
L1 176 1 168
L1 168 1 160
L1 160 1 152
L1 152 1 144
L1 144 1 136
L1 136 1 128
L1 128 1 120
L1 120 1 112
L1 112 1 104
L1 104 1 96
L1 96 1 88
L1 88 1 80
L1 80 1 72
L1 72 1 64
L1 64 1 56
L1 56 1 48
L1 48 1 40
L1 40 1 32
L1 32 1 24
L1 24 1 16
L1 16 1 15
L1 15 1 14
L1 14 1 13
L1 13 1 12
L1 12 1 11
L1 11 1 10
L1 10 1 9
L1 9 1 8
L1 8 1 7
L1 7 1 6
L1 6 1 5
L1 5 1 4
L1 4 1 3
L1 3 1 2
L1 2 2 2
L2 2 3 2
L3 2 4 2
L4 2 5 2
L5 2 6 2
L6 2 7 2
L7 2 8 2
L8 2 9 2
L9 2 10 2
L10 2 11 2
L11 2 12 2
L12 2 13 2
L13 2 14 2
L14 2 15 2
L15 2 16 2
L16 2 17 2
L17 2 18 2
L18 2 19 2
L19 2 20 2
L20 2 21 2
L21 2 22 2
L22 2 23 2
L23 2 24 2
L24 2 25 2
L25 2 26 2
L26 2 27 2
L27 2 28 2
L28 2 29 2
L29 2 30 2
L30 2 31 2
L31 2 32 2
L32 2 33 2
L33 2 34 2
L34 2 35 2
L35 2 36 2
L36 2 37 2
L37 2 38 2
L38 2 39 2
L39 2 40 2
L40 2 41 2
L41 2 42 2
L42 2 43 2
L43 2 44 2
L44 2 45 2
L45 2 46 2
L46 2 47 2
L47 2 48 2
L48 2 49 2
L49 2 50 2
L50 2 51 2
L51 2 52 2
L52 2 53 2
L53 2 54 2
L54 2 55 2
L55 2 56 2
L56 2 57 2
L57 2 69 2
L69 2 81 2
L81 2 93 2
L93 2 105 2
L105 2 117 2
L117 2 129 2
L129 2 141 2
L141 2 153 2
L153 2 165 2
L165 2 177 2
L177 2 189 2
L189 2 201 2
L201 2 213 2
L213 2 225 2
L225 2 237 2
L237 2 249 2
L249 2 261 2
L261 2 273 2
L273 2 285 2
L285 2 297 2
L297 2 309 2
L309 2 321 2
L321 2 333 2
L333 2 345 2
L345 2 357 2
L357 2 369 2
L369 2 381 2
L381 2 393 2
L393 2 405 2
L405 2 417 2
L417 2 429 2
L429 2 441 2
L441 2 453 2
L453 2 465 2
L465 2 477 2
L477 2 489 2
L489 2 501 2
L501 2 513 2
L9 10 21 10
L21 10 33 10
L33 10 45 10
L45 10 57 10
L57 10 69 10
L69 10 81 10
L81 10 93 10
L93 10 105 10
L105 10 117 10
L117 10 129 10
L129 10 141 10
L141 10 153 10
L153 10 165 10
L165 10 177 10
L177 10 189 10
L189 10 201 10
L201 10 213 10
L213 10 225 10
L225 10 237 10
L237 10 249 10
L249 10 261 10
L261 10 273 10
L273 10 285 10
L285 10 297 10
L297 10 309 10
L309 10 321 10
L321 10 333 10
L333 10 345 10
L345 10 357 10
L357 10 369 10
L369 10 381 10
L381 10 393 10
L393 10 405 10
L405 10 417 10
L417 10 429 10
L429 10 441 10
L441 10 453 10
L453 10 465 10
L465 10 477 10
L477 10 489 10
L489 10 501 10
L501 10 513 10
L513 10 525 10
L525 10 537 10
L537 10 549 10
L549 10 561 10
L561 10 573 10
L573 10 585 10
L585 10 597 10
L597 10 609 10
L609 10 621 10
L621 10 622 10
L622 10 623 10
L623 10 624 10
L624 10 625 10
L625 10 626 10
L626 10 627 10
L627 10 628 10
L628 10 629 10
L629 10 629 18
L629 18 629 26
L629 26 629 34
L629 34 629 42
L629 42 629 50
L629 50 629 58
L629 58 629 66
L629 66 629 74
L629 74 629 82
L629 82 629 90
L629 90 629 98
L629 98 629 106
L629 106 629 114
L629 114 629 122
L629 122 629 130
L629 130 629 138
L629 138 629 146
L629 146 629 154
L629 154 629 162
L629 162 629 170
L629 170 629 178
L629 178 629 186
L629 186 629 194
L629 194 629 202
L629 202 629 210
L629 210 629 218
L629 218 629 226
L629 226 629 234
L629 234 629 242
L629 242 629 250
L629 250 629 258
L629 258 629 266
L629 266 629 274
L629 274 629 282
L629 282 629 290
L629 290 629 298
L629 298 629 306
L629 306 629 314
L629 314 629 322
L629 322 629 330
L629 330 629 338
L629 338 629 346
L629 346 629 354
L629 354 629 362
L629 362 629 370
L629 370 629 378
L629 378 629 386
L629 386 629 394
L629 394 629 402
L629 402 629 410
L629 410 629 418
L629 418 629 426
L629 426 629 434
L629 434 629 442
L629 442 629 450
L629 450 629 458
L629 458 629 459
L629 459 629 460
L629 460 629 461
L629 461 629 462
L629 462 629 463
L629 463 629 464
L629 464 629 465
L629 465 629 466
L629 466 629 467
L629 467 629 468
L629 468 629 469
L629 469 629 470
L629 470 628 470
L628 470 627 470
L627 470 626 470
L626 470 625 470
L625 470 624 470
L624 470 623 470
L623 470 622 470
L622 470 621 470
L621 470 620 470
L620 470 619 470
L619 470 618 470
L618 470 617 470
L617 470 616 470
L616 470 615 470
L615 470 614 470
L614 470 613 470
L613 470 612 470
L612 470 611 470
L611 470 610 470
L610 470 609 470
L609 470 608 470
L608 470 607 470
L607 470 606 470
L606 470 605 470
L605 470 604 470
L604 470 603 470
L603 470 602 470
L602 470 601 470
L601 470 600 470
L600 470 599 470
L599 470 598 470
L598 470 597 470
L597 470 596 470
L596 470 595 470
L595 470 594 470
L594 470 593 470
L593 470 592 470
L592 470 591 470
L591 470 590 470
L590 470 578 470
L578 470 566 470
L566 470 554 470
L554 470 542 470
L542 470 530 470
L530 470 518 470
L518 470 506 470
L506 470 494 470
L494 470 482 470
L482 470 470 470
L470 470 458 470
L458 470 446 470
L446 470 434 470
L434 470 422 470
L422 470 410 470
L410 470 398 470
L398 470 386 470
L386 470 374 470
L374 470 362 470
L362 470 350 470
L350 470 338 470
L338 470 326 470
L326 470 314 470
L314 470 302 470
L302 470 290 470
L290 470 278 470
L278 470 266 470
L266 470 254 470
L254 470 242 470
L242 470 230 470
L230 470 218 470
L218 470 206 470
L206 470 194 470
L194 470 182 470
L182 470 170 470
L170 470 158 470
L158 470 146 470
L146 470 134 470
L134 470 122 470
L122 470 110 470
L110 470 98 470
L98 470 86 470
L86 470 74 470
L74 470 62 470
L62 470 50 470
L50 470 38 470
L38 470 26 470
L26 470 14 470
L14 470 13 470
L13 470 12 470
L12 470 11 470
L11 470 10 470
L10 470 9 470
L9 470 8 470
L8 470 8 469
L8 469 8 468
L8 468 8 467
L8 467 8 466
L8 466 8 465
L8 465 8 464
L8 464 8 463
L8 463 8 462
L8 462 8 461
L8 461 8 460
L8 460 8 459
L8 459 8 458
L8 458 8 457
L8 457 8 456
L8 456 8 455
L8 455 8 454
L8 454 8 453
L8 453 8 452
L8 452 8 451
L8 451 8 450
L8 450 8 449
L8 449 8 448
L8 448 8 447
L8 447 8 446
L8 446 8 445
L8 445 8 444
L8 444 8 443
L8 443 8 442
L8 442 8 441
L8 441 8 440
L8 440 8 439
L8 439 8 438
L8 438 8 437
L8 437 8 436
L8 436 8 435
L8 435 8 434
L8 434 8 433
L8 433 8 432
L8 432 8 431
L8 431 8 430
L8 430 8 429
L8 429 8 428
L8 428 8 427
L8 427 8 426
L8 426 8 425
L8 425 8 424
L8 424 8 423
L8 423 8 422
L8 422 8 421
L8 421 8 420
L8 420 8 419
L8 419 8 418
L8 418 8 417
L8 417 8 416
L8 416 8 415
L8 415 8 414
L8 414 8 413
L8 413 8 412
L8 412 8 411
L8 411 8 410
L8 410 8 409
L8 409 8 408
L8 408 8 407
L8 407 8 406
L8 406 8 405
L8 405 8 404
L8 404 8 403
L8 403 8 402
L8 402 8 401
L8 401 8 400
L8 400 8 399
L8 399 8 398
L8 398 8 397
L8 397 8 396
L8 396 8 395
L8 395 8 394
L8 394 8 393
L8 393 8 392
L8 392 8 391
L8 391 8 390
L8 390 8 389
L8 389 8 381
L8 381 8 373
L8 373 8 365
L8 365 8 357
L8 357 8 349
L8 349 8 341
L8 341 8 333
L8 333 8 325
L8 325 8 317
L8 317 8 309
L8 309 8 301
L8 301 8 293
L8 293 8 285
L8 285 8 277
L8 277 8 269
L8 269 8 261
L8 261 8 253
L8 253 8 245
L8 245 8 237
L8 237 8 229
L8 229 8 221
L8 221 8 213
L8 213 8 205
L8 205 8 197
L8 197 8 189
L8 189 8 181
L8 181 8 173
L8 173 8 165
L8 165 8 157
L8 157 8 149
L8 149 8 141
L8 141 8 133
L8 133 8 125
L8 125 8 117
L8 117 8 109
L8 109 8 101
L8 101 8 93
L8 93 8 85
L8 85 8 77
L8 77 8 69
L8 69 8 61
L8 61 8 53
L8 53 8 45
L8 45 8 37
L8 37 8 29
L8 29 8 21
L8 21 8 20
L8 20 8 19
L8 19 8 18
L8 18 8 17
L8 17 8 16
L8 16 8 15
L8 15 8 14
L8 14 8 13
L8 13 8 12
L8 12 8 11
L8 11 8 12
L8 12 8 13
L8 13 8 14
L8 14 8 13
L8 13 8 12
L8 12 8 11
L8 11 8 10
XxZ
F32 6
O8
XxA
L319 53 319 61
L319 61 319 69
L319 69 319 77
L319 77 319 85
L319 85 319 93
L319 93 319 101
L319 101 319 109
L319 109 319 117
L319 117 319 125
L319 125 319 133
L319 133 319 141
L319 141 319 149
L319 149 319 157
L319 157 319 165
L319 165 319 173
L319 173 319 181
L319 181 319 189
L319 189 319 197
L319 197 319 205
L319 205 319 213
L319 213 319 221
L319 221 319 229
L319 229 319 237
L319 237 319 245
L319 245 319 253
L319 253 319 261
L319 261 319 269
L319 269 319 277
L319 277 319 285
L319 285 319 293
L319 293 319 301
L319 301 319 309
L319 309 319 317
L319 317 319 325
L319 325 319 333
L319 333 319 341
L319 341 319 349
L319 349 319 357
L319 357 319 365
L319 365 319 373
L319 373 319 381
L319 381 319 389
L319 389 319 397
L319 397 319 405
L319 405 319 413
L319 413 319 421
L319 421 319 429
XxZ
O9
XxA
L319 15 331 15
L331 15 343 15
L343 15 355 15
L355 15 367 15
L367 15 379 15
L379 15 391 15
L391 15 403 15
L403 15 415 15
L415 15 427 15
L427 15 439 15
L439 15 451 15
L451 15 463 15
L463 15 475 15
L475 15 487 15
L487 15 499 15
L499 15 511 15
L511 15 523 15
L523 15 535 15
L535 15 547 15
L547 15 559 15
L559 15 571 15
L571 15 583 15
L583 15 595 15
L595 15 607 15
L607 15 619 15
L619 15 620 15
L620 15 621 15
L621 15 622 15
L622 15 623 15
L623 15 624 15
L624 15 624 23
L624 23 624 31
L624 31 624 39
L624 39 624 47
L624 47 624 55
L624 55 624 63
L624 63 624 71
L624 71 624 79
L624 79 624 87
L624 87 624 95
L624 95 624 103
L624 103 624 111
L624 111 624 119
L624 119 624 127
L624 127 624 135
L624 135 624 143
L624 143 624 151
L624 151 624 159
L624 159 624 167
L624 167 624 175
L624 175 624 183
L624 183 624 191
L624 191 624 199
L624 199 624 207
L624 207 624 215
L624 215 624 223
L624 223 624 231
L624 231 624 239
L624 239 624 247
L624 247 624 255
L624 255 624 263
L624 263 624 271
L624 271 624 279
L624 279 624 287
L624 287 624 295
L624 295 624 303
L624 303 624 311
L624 311 624 319
L624 319 624 327
L624 327 624 335
L624 335 624 343
L624 343 624 351
L624 351 624 359
L624 359 624 367
L624 367 624 375
L624 375 624 383
L624 383 624 391
L624 391 624 399
L624 399 624 407
L624 407 624 415
L624 415 624 423
L624 423 624 431
L624 431 624 439
L624 439 624 447
L624 447 624 455
L624 455 624 456
L624 456 624 457
L624 457 624 458
L624 458 624 459
L624 459 624 460
L624 460 624 461
L624 461 624 462
L624 462 624 463
L624 463 624 464
L624 464 624 465
L624 465 612 465
L612 465 600 465
L600 465 588 465
L588 465 576 465
L576 465 564 465
L564 465 552 465
L552 465 540 465
L540 465 528 465
L528 465 516 465
L516 465 504 465
L504 465 492 465
L492 465 480 465
L480 465 468 465
L468 465 456 465
L456 465 444 465
L444 465 432 465
L432 465 420 465
L420 465 408 465
L408 465 396 465
L396 465 384 465
L384 465 372 465
L372 465 360 465
L360 465 348 465
L348 465 336 465
L336 465 324 465
L324 465 312 465
L312 465 300 465
L300 465 288 465
L288 465 276 465
L276 465 264 465
L264 465 252 465
L252 465 240 465
L240 465 228 465
L228 465 216 465
L216 465 204 465
L204 465 192 465
L192 465 180 465
L180 465 168 465
L168 465 156 465
L156 465 144 465
L144 465 132 465
L132 465 120 465
L120 465 108 465
L108 465 96 465
L96 465 84 465
L84 465 72 465
L72 465 60 465
L60 465 48 465
L48 465 36 465
L36 465 24 465
L24 465 23 465
L23 465 22 465
L22 465 21 465
L21 465 20 465
L20 465 19 465
L19 465 18 465
L18 465 17 465
L17 465 16 465
L16 465 15 465
L15 465 14 465
L14 465 13 465
L13 465 12 465
L12 465 12 457
L12 457 12 449
L12 449 12 441
L12 441 12 433
L12 433 12 425
L12 425 12 417
L12 417 12 409
L12 409 12 401
L12 401 12 393
L12 393 12 385
L12 385 12 377
L12 377 12 369
L12 369 12 361
L12 361 12 353
L12 353 12 345
L12 345 12 337
L12 337 12 329
L12 329 12 321
L12 321 12 313
L12 313 12 305
L12 305 12 297
L12 297 12 289
L12 289 12 281
L12 281 12 273
L12 273 12 265
L12 265 12 257
L12 257 12 249
L12 249 12 241
L12 241 12 233
L12 233 12 225
L12 225 12 217
L12 217 12 209
L12 209 12 201
L12 201 12 193
L12 193 12 185
L12 185 12 177
L12 177 12 169
L12 169 12 161
L12 161 12 153
L12 153 12 145
L12 145 12 137
L12 137 12 129
L12 129 12 121
L12 121 12 113
L12 113 12 105
L12 105 12 97
L12 97 12 89
L12 89 12 81
L12 81 12 73
L12 73 12 65
L12 65 12 57
L12 57 12 49
L12 49 12 41
L12 41 12 33
L12 33 12 25
L12 25 12 17
L318 15 319 15
L319 15 320 15
L320 15 321 15
L321 15 322 15
L322 15 323 15
L323 15 324 15
L324 15 325 15
L325 15 326 15
L326 15 327 15
L327 15 328 15
L328 15 329 15
L329 15 330 15
L330 15 331 15
L331 15 332 15
L332 15 333 15
L333 15 334 15
L334 15 335 15
L335 15 336 15
L336 15 337 15
L337 15 338 15
L338 15 339 15
L339 15 340 15
L340 15 341 15
L341 15 342 15
L342 15 343 15
L343 15 344 15
L344 15 345 15
L345 15 346 15
L346 15 345 15
L345 15 344 15
L344 15 343 15
L343 15 342 15
L342 15 341 15
L341 15 340 15
L340 15 339 15
L339 15 327 15
L327 15 315 15
L315 15 303 15
L303 15 291 15
L291 15 279 15
L279 15 267 15
L267 15 255 15
L255 15 243 15
L243 15 231 15
L231 15 219 15
L219 15 207 15
L207 15 195 15
L195 15 183 15
L183 15 171 15
L171 15 159 15
L159 15 147 15
L147 15 135 15
L135 15 123 15
L123 15 111 15
L111 15 99 15
L99 15 87 15
L87 15 75 15
L75 15 63 15
L63 15 51 15
L51 15 39 15
L39 15 27 15
L27 15 15 15
L15 15 14 15
L14 15 13 15
L13 15 12 15
L12 21 12 20
L12 20 12 19
L12 19 12 18
L12 18 12 17
L12 17 12 16
XxZ
O9
XxA
O0
ti322 38 SATURN19
ATRIAL SEPTAL DEFECT
O9
ti320 36 SATURN19
ATRIAL SEPTAL DEFECT
XxZ
O8
XxA
te25 57 TRADIT13
Atrial septal defect (ASD) is the second most
common congenital defect and is usually
asymptomatic until middle age. Early, most
have cardiomegaly, dilated pulmonary
arteries with increased vascularity and an
asymptomatic murmur. If the defect has not
been closed by the fifth decade, almost all
patients will be symptomatic with congestive
heart failure, right ventricular failure,
arrhythmias or paradoxical embolism.
Preferably, the defect should be closed
between 2-5 years of age. If the defect is
closed before the onset of symptoms, the
natural history is similar to those patients
without congenital heart disease. However,
there is an increased incidence of
supraventricular tachycardia, atrial flutter
and sinus node dysfuncion in those ASD
patients that have been repaired.
~
XxZ
O12
XxA
te25 313 TRADIT13
DIAGNOSIS
~
XxZ
O8
XxA
te25 329 TRADIT13
There is a moderately loud systolic ejection
murmur that can be heard in the 2nd and 3rd
interspaces parasternally which is due to
increased pulmonary artery flow. S2
demonstrates fixed splitting of the second
heart sound and does not vary with
respirations. In ostium secundum defects,
right axis deviation or right ventricular
hypertrophy may be present. Almost all
cases of ASD will have either incomplete or
~
XxZ
XxA
te325 57 TRADIT13
complete Right bundle branch block and a
superior axis deviation is seen in ostium
primum defects. In patients with sinus
venosus defects, the P axis is directed to the
left of +15 degrees. Chest x-ray will show an
enlarged right atrium and ventricle, small
aortic knob, and large pulmonary arteires
with increased pulmonary vascularity.
Echocardiography can depict a large right
atrium and ventricle secondary to right
ventricular overload. Echo with saline bubble
contrast plus Doppler flow studies will detect
the shunting and increased pulmonary flow.
MRI is also capable of demonstrating the
anatomy. Radionuclide flow studies are able
to quantify the left to right shunt. Cardiac
catheterization will demonstrate the increase
in oxygen saturation between the venae
cavae and the right ventricle which is due to
the admixture of oxygenated blood from the
left atrium, measure pulmonary vascular
resistance and quantify the shunt. If right and
left ventricular contrast angiography is done,
associated anomalous pulmonary venous
drainage or valvular abnormalities may be
appreciated.
~
XxZ
O12
XxA
te325 401 PLAZA14
Ostium Secundum Defect
~
XxZ
O8
XxA
te325 417 TRADIT13
The ostium secundum or fossa ovalis defect
is the most common type of ASD. Small
~
XxZ
O12
XxA
te325 449 TRADIT13
CONTINUED NEXT PAGE
~
XxZ