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Answer 2
  1. Pulmonary valve stenosis. Survival to adulthood is expected in most patients with pulmonary valves with systolic ejection murmurs and wide splitting of the second heart sound. The diagnosis is usually made by echocardiography. Pulmonic stenosis is one of the most common congenital heart defects, occurring in approximately 10% of the adult population.1 Approximately 25% of patients with pulmonic stenosis also have an atrial septal defect. The most common symptom of pulmonary valve stenosis is shortness of breath with exertion; cyanosis is also common.

     Alexander RW, Schlant RC, eds: Hurst’s The Heart, 8th ed. New York: McGraw-Hill, 1994.

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