Hypertrophic Subaortic Stenosis with Ostium Secundum Atrial Septal Defect

¹ Staff Cardiologist, Naval Hospital San Diego
² Chief of Cardiology, Naval Hospital, San Diego

The first known case of idiopathic hypertrophic subaortic stenosis (IHSS) with an ostium secundum atrial septal defect and no other cardiac defects is described. The physical findings were typical of IHSS. The presence of an associated left-to-right shunt was suggested by the electrocardiogram (incomplete right bundle branch block) and chest radiograph (increased pulmonary flow). The second heart sound was normally split. The advantages and disadvantages of surgery in this combined lesion are discussed. Because this patient was asymptomatic, with no evidence of pulmonary vascular disease and no resting subaortic gradient, surgery was not advised at this time.