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Dyspnoea on exertion in a 15-year-old boy
  1. Rakesh Jain,
  2. Kader Muneer,
  3. Sajeev C G
  1. Department of Cardiology, Government Medical College, Calicut, Kerala, India
  1. Correspondence to Dr Rakesh Jain, Department of Cardiology, Government Medical College, Calicut 673008, Kerala, India; dr_rkjain123{at}

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Clinical Introduction

A 15-year-old male patient presented with dyspnoea on exertion for 6 months. He had no significant medical history. His blood pressure and pulse rate were within normal limits. Cardiac auscultation revealed a grade 4/6 (Levine scale) high-frequency pansystolic murmur over the cardiac apex conducting to left axilla as well as to base of the heart. Haematological and biochemical evaluation including 12-lead ECG were within normal limits. Chest X-ray showed mild cardiomegaly. Transthoracic echocardiography (TTE) with colour Doppler imaging was done (figure 1).

Figure 1

(A) Transthoracic echocardiography (TTE) with colour Doppler, apical four chamber view, (B) 2D TTE, parasternal short axis view and (C) TTE with colour Doppler, parasternal short axis view.


Which of the following is the most likely diagnosis?

  1. Complete atrioventricular canal defect …

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  • Contributors All the authors are fully involved in data collection and preparation of the manuscripts.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; internally peer reviewed.