Images in Clinical Medicine

Kim Eagle, M.D., Editor

Ostium Secundum Atrial Septal Defect

Roberto M. Lang, M.D., and Richard H. Marcus, M.D.

N Engl J Med 1995; 332:1337May 18, 1995

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Article

Figure 1 Transesophageal echocardiography was performed in a 23-year-old patient who presented with exertional dyspnea, fatigue, and palpitations. Cardiac auscultation revealed fixed splitting of the second heart sound and a short mid-diastolic murmur (grade ^1/4) in the fourth left intercostal space parasternally. An rSR pattern was present in precordial lead V₁ on the electrocardiogram. Doppler studies showed a pulmonary–systemic flow ratio (QP/QS) of 2.3:1. The patient underwent successful surgical closure of the atrial septal defect.

Kim Eagle, M.D.

Roberto M. Lang, M.D.
Richard H. Marcus, M.D.
University of Chicago, Chicago, IL 60637