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A 29-year-old man presented with severe dyspnea and hemoptysis. He said he had always had a reduced capacity for exercise as compared with his peers. He had an elevated jugular venous pressure, a right ventricular heave, a loud pulmonic second sound, and a grade 2 systolic ejection murmur at the left upper sternal border. An electrocardiogram (Panel A) showed sinus rhythm, right-axis deviation, left atrial enlargement, right ventricular hypertrophy with strain, and an S1Q3T3 pattern (an S wave in lead I and a Q wave and an inverted T wave in lead III). An echocardiogram (Panel B) showed normal left . . . [Full Text of this Article] |