Зображення 00722. Ejection murmur

This actively training physically fit boy was referred for investigation of a murmur. Pulse at rest approx. 50 bpm, a short, low-pitched, soft ejection murmur that is second-degree at the most is heard from the apex. ECG, chest radiograph, blood pressure and echocardiography are all normal. Phonogram shows a short murmur close to midsystole with a maximum frequency of 100 Hz on the spectrogram. Age 15.3 years. Auscultation area: left fourth intercostal space (LIC4).