With a small hole in the heart, the infant or young child is relatively asymptomatic. With larger defects tiredness, shortness of breath on exertion, and frequent infection of the lungs may occur. These symptoms are more obvious as heart failure worsens. A soft heart murmur is usually heard

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• I. CLINICAL STUDY
  Study question: A study by Attie et al. assessed weather surgical treatment of atrial septal defects in patients over age 40 improves their long-term outcome.
• BIBLIOGRAPHY
  Attie, F., Rosas, M., Granados, N. et al. Surgical treatment for secundum atrial septal defects in patients greater than 40 years old. J. Am. Coll. Cardiol., 58: 2035–4, 2001.