The following is false about Atrial septal defect –
In ASD there is left to right shunt.

Clinical manifestations of ASD

Patients with ASD are generally asymptomatic.
Mild effort intolerance and respiratory tract infection may occur.
CHF is rare.

Physical examination

Parasternal impulse
Systolic thrill at 2nd left interspace.
Accentuation of S1 due to loud tricuspid component.
Wide split and fixed S2
Ejection systolic murmur at the second and third left interspaces.
Delayed diastolic murmur at the lower left sternal border.
ASD with mitral stenosis → Lutembacher syndrome.
Ostium secundum most common
Right to Left Shunt
May be associated with TAPVC
CCF is very rare
Right to Left Shunt