Summary:

The patient's echocardiogram confirmed the presence of a VSD of the membranous septum with a small left-to-right shunt (from the left ventricle into the right ventrical). There was no other abnormality.

Click to review auscultation.

Lessons:

1. The loudness of the murmur in this case is not proportional to the severity of the defect. Very small ventricular septal defects, referred to as "Maladie du Roger", cause very loud systolic murmurs.
2. This patient is planning to get married. Her children will be at slightly greater risk (about 2% probability) of being born with a congenital cardiac abnormality as compared to the general population (about 0.6% probability).

 

Case 12 is now finished.