ABSTRACT
The charts of 115 patients with the diagnosis of atrial septal defect who were seen in the Echocardiographic Department at the National Institute of Cardiovascular Diseases, Karachi, during January to December 1993, were reviewed for clinical profile. Only 40% of patients were 18 years of age or less while 60% were older than 18 years. Most adults with ASD were symptomatic while most children were asymptomatic. Pulmonary arterial hypertension was noted in 6.5% children and 16.7% of adults. On follow up 49% of patients were lost to follow up. It was concluded that ASD was detected much too late and that great number of adults are expected to be symptomatic with ASD. Significant number are expected to develop pulmonary vascular disease. It is suggested that physical examinations be made frequently during childhood for early detection of ASD