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Previous Volume 333:513-514 August 24, 1995 Number 8 Next

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Leonardo da Vinci's description in 1513 of a "perforating channel" in the atrial septum is believed to be the first recorded account of a congenital malformation of the human heart.¹ Atrial septal defects often go unrecognized for decades, because there are no symptoms and because the physical signs (such as a soft pulmonary-flow murmur and fixed splitting of the second heart sound) are subtle. Survival into adulthood is the rule, and patients sometimes live to advanced ages.^2,3,4,5,6,7 Indeed, the renowned cardiologist Paul Wood remarked, "In any series of geriatric necropsies atrial septal defect is always represented."⁸ Life expectancy is not . . . [Full Text of this Article]

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