Left Ventricular Outflow-Tract Obstruction With an Ostium Primum Defect

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Abstract
Defects of the ostium primum have been described with a number of associated cardiac anomalies. Seven patients with this malformation and obstruction of the left ventricular outflow tract have been described in the literature.1-4 One patient with an ostium secundum defect and idiopathic hypertrophic subaortic stenosis has been described.5 The combination of the ostium primum defect and left ventricular outflow-tract obstruction occurred in two additional patients. The findings on physical examination on cardiac catheterization, and at operation are presented, and in one patient, observations were made at necropsy. Patient Summaries Patient 1, a 29-year-old man, was seen by a physician after blunt injury to the chest. At that time he described symptoms antedating the injury consisting of dyspnea on moderate exertion for six months, increasing fatigue of one month's duration, minimal retrosternal tightness on vigorous exercise relieved by rest, and frequent prolonged "chest colds" during the winter. The

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