Four patients with atrial septal defects and congestive heart failure in the first year of life had none of the classic auscultatory findings of atrial septal defect. Three of four had murmurs suggestive of innocent pulmonaryartery branch stenosis.
(JAMA 234:1250-1251, 1975)
Toews WH, Nora JJ, Wolfe RR. Presentation of Atrial Septal Defect in Infancy. JAMA. 1975;234(12):1250–1251. doi:10.1001/jama.1975.03260250042025