Abstract:Clinical data: heart murmur, cyanosis and fatigue are observed from birth, with clear worsening in recent years. Without proper medical treatment, 83% hematocrit and hemoglobin concentration of 28 g were recently found. Repeated hemapheresis decreased hematocrit to 73%. No specific medication had been administered since birth. Precordial systolic impulsions were discrete, sharp systolic thrill across the left sternal border. Apical impulse was not palpable. Heart sounds were very loud and systolic murmur was s… Show more
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