Clinical features and management of secundum atrial septal defect in infants and children

This retrospective study aimed to review the clinical features and management of patients with secundum atrial septal defect (ASD 2°). The subjects studied were 90 boys (39.8%) and 136 girls (60.2%), treated at the Outpatient Clinic, Cardiology Division, Department of Child Health, Cipto Mangunkusumo Hospital, Jakarta, Indonesia, from January 1, 1983 to December 31, 1992. Clinical assessment and management were evaluated by one of the authors. Electrocardiographic, radiographic, and hemodynamic findings were analyzed by the experts. The diagnostic procedure was completed with echocardiographic examination since January 1987. This study discloses several findings: (1) ASD 2° affected girls more than boys, the sex ratio was 1,5:1; (2) The diagnosis of ASD 2° in infants was increased after the advent of echocardiography; (3) While typical auscultatory findings could be heard in older ASD cases, the clinical features were not specific in young infants; (4) Growth retardation, cardiomegaly and right bundle branch block were common in large ASD 2°; (5) Simple closure of ASD 2° was the procedure of choice.