This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pediatrics
The following is false about Atrial septal defect – 
Select and explain. 
A. Ostium secundum most common, B. Right to Left Shunt, C. May be associated with TAPVC, D. CCF is very rare
B: Right to Left Shunt
Answer: B: Right to Left Shunt 
Explanation: In ASD there is left to right shunt.

Clinical manifestations of ASD

Patients with ASD are generally asymptomatic.
Mild effort intolerance and respiratory tract infection may occur.
CHF is rare.

Physical examination

Parasternal impulse
Systolic thrill at 2nd left interspace.
Accentuation of S1 due to loud tricuspid component.
Wide split and fixed S2
Ejection systolic murmur at the second and third left interspaces.
Delayed diastolic murmur at the lower left sternal border.
ASD with mitral stenosis → Lutembacher syndrome.