You are incorrect - the best diagnosis based on the history in our patient is a left-to-right shunt.


Your choice: Hypertrophic obstructive cardiomyopathy
Patients with hypertrophic obstructive cardiomyopathy typically do not develop a heart murmur until late childhood or early adulthood. Once the obstruction is manifest, patient's symptoms usually include exercise intolerance and, in some cases, chest pain and cardiac rhythm abnormalities.