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Quadri-leaflet pulmonary valve: unusual cause of unexplained murmur
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A 43 year old woman was referred for cardiac magnetic resonance (CMR) imaging for investigation of a systolic murmur.
The patient was asymptomatic with no previous episodes of chest pain, breathlessness, palpitations, or syncope. Her exercise tolerance was good. There were no risk factors for ischaemic heart disease, no history of hypertension or diabetes, and she had never smoked.
On examination she …