<prompt> A middle aged lady was diagnosed to incidentally have a ejection systolic murmur at the pulmonary area. A fixed wide split of the second heart sound was also noted. The diagnosis is:-Tetralogy of FallotAtrial septal defectMitral stenosisMitral valve prolapse  <response>: Classically presents as an asymptomatic patient with a flow murmur in the pulmonary area and a fixed wide split of S2.Atrial septal defects occur most commonly in the region of the fossa ovalis, referred to as secundum-type defects .Additional atrial septal defects include defects of the sinus venosus and atrium primum. Color flow Doppler echocardiography is usually sufficient for diagnosis of a secundum-type atrial septal defect, but agitated saline is generally needed for the diagnosis of other types of atrial septal defects. 