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Atrioventricular septal defect with cor triatriatum
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A 25 year old man with Down's syndrome (trisomy 21) was evaluated for dyspnoea. Physical examination revealed cyanosis (systemic saturation 60%), clubbing, oedema, accentuated pulmonary component of second heart sound, and hepatomegaly. Chest x ray demonstrated cardiomegaly and pulmonary venous congestion. ECG revealed a sinus rhythm, QRS axis of 240°, first degree atrioventricular block (P-R …