Atrial septal defect Quiz: Ace Your Exams
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A 15-year-old boy comes to his outpatient provider for evaluation of fatigue and reduced exercise tolerance. He reports having difficulty keeping up with his friends while playing soccer. The patient recently immigrated to the United States. He previously had limited access to medical care. Vitals are within normal limits. On physical examination, a heart murmur can be auscultated at the left lower sternal border. No cyanosis of the skin or mucosal membranes is observed. Cardiac catheterization is performed and yields the results shown below. Which of the following is the most likely explanation of these findings?


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