ASD with Mitral incompetence with heart failure

A boy of 7 years presented with dyspnoea, precordial bulging, hepatomegaly and leg oedema. Clinically he had pansystolic murmer over the left lower sternal border with loud second sound. Provisionally it was thought to be a case of VSD with heart failure.Xay showed cardiomegaly with pulmonary oedema. In ECG, there was right ventricular hypertrophy and right atrial hypertropy. In hospital, the patient had ungone a critical phase developing shock. When the shock was overcome, in Echo, the cardiologist commented ASD(secundum) with mild mitral incompetence and pulmonary hypertension.
But if we clinically corralate the case, it is better conform with ASD(primum) with Mitral incompetence with heart failure.
Bdoza