It IS somewhat paradoxic that often, even in persons of advanced years, the question of possible congenital cardiac disease enters prominently into the problems of differential diagnosis and prognosis. The commonest of all congenital defects, patent foramen ovale, frequently gives rise to no symptoms or signs throughout life and is discovered only at autopsy. Lutembacher's syndrome, a large atrial septal defect with concomitant mitral stenosis,1 is an extremely uncommon combination of congenital lesions, which often does not become apparent until late in life, and the diagnosis of which is likely to be missed until autopsy. McGinn and White,2 however, in 1933, pointed out that this combination of lesions may well be recognized before death if the possibilities of its occurrence and the distinctive roentgenographic findings are borne in mind, and Geiger and Anderson3 have recently recorded a case in which the diagnosis was made ante mortem.
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