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"Left Heart Failure" and Atrial Septal Defects.

Hans H. Hecht, M.D., F.A.C.P.; Gerasim Tikoff, M.D.; Alexander M. Schmidt, M.D.; and Hiroshi Kuida, M.D.
Ann Intern Med. 1965;62(5):1071. doi:10.7326/0003-4819-62-5-1071_2
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Complete clinical, laboratory, and repeated hemodynamic studies were carried out on 38 cases of large atrial septal defect of the secundum type ranging in age from 1 to 71 (mean, 38.6 years). The following observations were made:

(1) Heart failure due to right ventricular overload is characterized in this entity by maintenance of normal atrial and normal end ventricular diastolic pressures, decreased right ventricular forward stroke volume, and decrease in left to right, and appearance of right to left shunt.

(2) An elevation of common atrial pressure (in the absence of concomitant mitral stenosis) apparently signals left ventricular failure and


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