Snapshot A 40-year-old man presents to his physician’s office for a routine physical. In the past few years, he has neglected to attend these appointments. He reports having no complaints, except for some shortness of breath with exertion. Physical exam reveals a new murmur, characterized by a wide and fixed split S2 heart sound, especially during inspiration. An echocardiogram reveals an atrial septal defect. Introduction Clinical definition login to view 1 more bullet Etiology Ostium secundum defect (most common) login to view 1 more bullet Ostium primum defect login to view 1 more bullet Pathogenesis login to view 3 more bullets Associated conditions login to view 3 more bullets Epidemiology Demographics login to view 1 more bullet Risk factors login to view 2 more bullets Presentation Symptoms login to view 5 more bullets Physical exam login to view 8 more bullets Imaging Radiography login to view 7 more bullets Echocardiography login to view 5 more bullets Studies Electrocardiogram login to view 5 more bullets Making the diagnosis login to view 1 more bullet Differential Ventricular septal defect login to view 2 more bullets Aortic stenosis login to view 3 more bullets Treatment Management approach login to view 2 more bullets Medical login to view 4 more bullets Operative login to view 13 more bullets Complications Heart failure Eisenmenger syndrome Paradoxical emboli login to view 1 more bullet Prognosis May be asymptomatic or may progress to heart failure Mortality highest in infants and adults > 65 years of age