This well-grown girl who is adopted from another country was found to have a fourth-degree continuous murmur with throbbing pulses. Echocardiography showed a large ductus arteriosus but no other defects. The child was referred for corrective surgery. Phonogram shows a consistent (systolic-diastolic) murmur that becomes louder towards endsystole and is quieter in diastole. The flow is rapid in systole, which is when the spectrogram shows the highest frequencies. Age 2.6 years. Area of auscultation: left second ic (LIC2).