Atrial Septal Defect of the Ostium Secundum Type in A 101-Year-Old Patient

The patient was a 101-year-old woman whose chief complaints were difficulty of breathing and high fever. The history of the present illness included paroxysmal atrial flutter which was untreated, but she had not developed heart failure.At admission, auscultation of the chest revealed moist rales and systolic murmur but did not clearly show the presence of fixed splitting of S2. X-ray examination of the chest showed a cardiothoracic ratio of 61%, moderate bilateral pulmonary congestion, pleural fluid, and enlarged pulmonary arteries. Electrocardiogram showed atrial flutter with a heart rate of approximately 150 beats/minute. Echocardiographic examination revealed an atrial septal defect (ASD) of the ostium secundum type (left to right shunt) and right ventricular pressure 71 mmHg. The diameter of the ASD was approximately 10 mm.She began receiving an antibiotic and a diuretic immediately after admission, but died on the second day of hospitalization.This case could be the oldest individual with ASD among those reported to date.