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A 43-year-old woman with a history of ventricular septal defect (VSD) closure, pulmonary hypertension and partial Eisenmenger's physiology presented with in-field v-fib arrest. She was defibrillated to normal sinus rhythm. Echocardiography revealed dilated right ventricle (RV), right ventricular hypertrophy (RVH) and right ventricular systolic pressure (RVSP) of 88 mm Hg. A robust right-to-left shunt through a patent foramen ovale (PFO) was seen. A coronary CT angiogram revealed compressed left main coronary artery (LMCA) by severely dilated …
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