A 36-year-old woman with no previous cardiac history presented with 6 months of progressive exertional dyspnea. Assessments and investigations to date were nondiagnostic. A formal echocardiogram was pending. Assessment by the cardiology team revealed a right ventricular heave, palpable second heart sound, and a II/VI pansystolic murmur that was loudest at the apex.
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Published online: November 22, 2013
Accepted: November 18, 2013
Received: October 28, 2013
See page 465.e1 for disclosure information.
© 2014 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.