Our patient is an 18-year-old man who was referred for medical evaluation after a heart murmur was noted on a pre college physical examination.
The pertinent features of his history include normal growth and development and normal exercise tolerance.
A survey of the cardiac history revealed no palpitations, significant chest pain, shortness of breath, edema or syncope. There was no history of rheumatic fever. The patient was never told he had a heart murmur.
His father experienced a heart attack at age fifty, but there is no family history of congenital heart disease or sudden death. The patient has no history of hypertension and denies smoking or illegal drug use.