ECG and anamnestic remark unmask atrial septal defect in an asymptomatic young athlete

We report the case of a young athlete affected by an atrial septal defect in a potential variant of Holt-Oram Syndrome (HOS). He has always carried out competitive activity in the absence of symptoms. The integrated approach of medical history and of 12-lead ECG have led us to look for an ostium secundum-type atrial septal defect (OS-ASD). The suspected disease was subsequently documented with echocardiography. The diagnosis was corroborated from the presence of left anterior hemiblock (LAH) and right ventricular conduction delay on resting ECG and from history remark of polydactyly on the left foot. Thus, history, ECG and Echocardiography could provide sufficient information for an accurate diagnosis as well as, for decision making.