Unrepaired PTA in a 38-year-old woman with an uneventful pre
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Case report
A 41-year-old housewife initially presented to the Cardiology Department of Hedi Chaker Hospital in Tunisia in November 2011 with symptoms of exercise intolerance and occasional palpitations of several months’ duration. She had no family history of congenital defects. Three years earlier, when she was 38 years old, she gave birth to a normal baby after undergoing an uneventful full-term pregnancy and delivery.

Cyanosis and dyspnoea on exertion had been present throughout her life, but despite this, she appeared to have had a fairly normal life, being able to tolerate daily activities well. Two weeks prior to admission, she reported having experienced an exacerbation of dyspnoea.

She was a small-built woman and appeared deeply cyanosed on examination but not dyspnoeic at rest. Prominent clubbing of the fingers was noticeable. Congestion of the jugular veins was also striking. Her oxygen saturation in room air was about 80%. Physical examination revealed a mild systolic murmur over the left parasternal border and a loud second heart sound in the right second intercostal space.....

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4683288/
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