ATRIAL SEPTAL DEFECT IN INFANCY.

The case histories of seven infants with atrial septal defect are presented to draw attention to certain features and possible dangers of this defect in infancy. Four infants were asymptomatic but one failed to thrive and two died suddenly. Five had ejection murmurs and two, with pulmonary hypertension, had loud pan-systolic murmurs with a thrill. In two infants murmurs were noted at birth, but in five they were first heard between the ages of 1 and 6 months. The second pulmonary sound was initially narrowly split in all, but became widely split between the ages of 12 and 20 months. Electrocardiograms and chest roentgenograms were of little help at the outset but later showed findings characteristic of the defect after one year. All infants were catheterized; a left-to-right atrial shunt was detected in each instance. Pulmonary hypertension was present in two infants, one of whom died.