Snapshot A 15-year-old boy presents to his pediatrician’s office for exercise intolerance. He says he is unable to keep up with his friends during physical activities such as sports, which is new to him. On physical exam, a loud S1 and a fixed split S2 is appreciated during cardiac auscultation. He is sent for a chest radiograph, electrocardiogram, and echocardiogram for further evaluation. Introduction Clinical definition login to view 1 more bullet Epidemiology login to view 5 more bullets Etiology login to view 5 more bullets Pathogenesis login to view 3 more bullets Associated conditions login to view 3 more bullets Prognosis login to view 2 more bullets Presentation Symptoms login to view 5 more bullets Physical exam login to view 5 more bullets Imaging Radiography login to view 7 more bullets Echocardiography login to view 5 more bullets Studies Electrocardiogram login to view 5 more bullets Making the diagnosis login to view 1 more bullet Differential Ventricular septal defect login to view 2 more bullets Aortic stenosis login to view 3 more bullets Innocent/physiologic murmurs login to view 4 more bullets Treatment Management approach login to view 2 more bullets Medical login to view 4 more bullets Operative login to view 13 more bullets Complications Heart failure Eisenmenger syndrome Paradoxical emboli login to view 1 more bullet