Atrial Septal Defect in the Aged

T HE less obvious diseases occurring in the aged are often overlooked in clinical prac- tice and have been given little mention in medical literature. Atrial septal defect has a high incidence in youth and middle age. Among individuals over the age of 50 it is the most common major congenital defect.' The refinement of diagnostic criteria is made imperative by the fact that rapidly progres- sive cardiac failure (of relatively recent ori- gin) may occur in cases with atrial septal de- feet over the age of 60. Ellis has shown that such individuals may be successfully operated upon, with closure of the defects, and syinptomatic improvement.2 In the aged a well-defined clinical picture is often present, and may be seen with minimal impairment of cardiac function and no significant cardiac symlptoms.