atrial fibrillation, which increases in incidence with age
severe pulmonary hypertension with right ventricular failure - Eisenmenger's syndrome
infective endocarditis is a rare complication which nevertheless requires antibiotic prophylaxis prior to e.g. dental surgery. If this complication occurs in a patient with an ASD then this is highly suggestive of an ostium primum defect with infection of a cleft mitral valve. The ostium secundum type of ASD is remarkably resistant to infection.
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