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  • With advancing age, symptoms such as exercise intolerance, dyspnea, fatigue, and atrial arrhythmias (with or without palpitations) become more common; 90% of untreated patients experience these symptoms, or may show evidence of heart failure, by the age of 40 years.2,5,7 Swelling of the legs, feet, or abdomen and bluish skin color may also be symptoms of ASD.3 Further, a low-pitched diastolic murm
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