Arthur Selzer, M.D.
JAMA. 1954;154(2):129-135. doi:10.1001/jama.1954.02940360027008.
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A decade ago our knowledge of congenital heart disease was based primarily on the morphology of the malformations and on empirical observations permitting the establishment of clinical patterns and criteria for diagnosis, such as characteristic auscultatory findings, specific electrocardiographic changes and roentgenographic configurations. The recently introduced methods of investigation, such as cardiac catheterization, angiocardiography, and oximetry, permitted a more direct insight into the dynamic alterations that were brought about in these remarkable experiments of nature and thereby helped to place the diagnostic approach to congenital cardiac disease on a more comprehensive and rational basis.

Although the clinical syndromes associated with defects of the ventricular septum and of the atrial septum were recognized a long time ago, a diagnosis of septal defect was in the past considered acceptable because of the many similarities between the two types of septal defects. Recently, however, it became more and more evident that a communication


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