That congenital cardiovascular anomalies must be considered as possible causes of various symptoms developing during adult life is demonstrated by the detection of 29 cases of this sort within five years in a small adult cardiac clinic. The roentgenographic configuration of the heart and great vessels was often the first clue; data obtained by catheterizing the heart via either the antecubital or the saphenous vein were generally decisive. Left-to-right shunt anomalies were the commonest type in this group of 29. Nine of the lesions were interatrial septal defects, and detailed findings are given for these cases, all of which occurred in women. This experience showed that congenital heart disease which has escaped recognition in childhood may become significant in later life. In most instances the defect was of a type that is now curable by surgery.
Johnson JB, Lawlah JW, Hedgepath LE. CONGENITAL CARDIOVASCULAR ANOMALIES IN ADULTS. JAMA. 1957;165(8):915–922. doi:10.1001/jama.1957.02980260001001