Atrial septal defect (ASD) may be rarely associated with Eisenmenger syndrome (ES), the most advanced form of pulmonary vascular disease to complicate a congenital heart disease. In spite of availability of pediatric cardiologists and two-dimensional-echochardiography in many tertiary health care centers in Nigeria, late referral and late diagnosis of ASD still occur leading to the development of ES. We describe a case of a 19-year-old male with ASD who presented late with ES.
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