23rd September 2021

A 14-year-old female presents to her general practitioner (GP) with increased fatiguability over 5 months

A 14-year-old female presents to her general practitioner (GP) with increased fatiguability over 5 months. She had initially attributed this to working too hard for her school exams. Her past medical history includes asthma, for which she takes inhalers. There is no significant family history. Of note on examination, there is an ejection systolic murmur heard loudest at the upper left sternal edge, and there is a fixed splitting of the second heart sound. There are no further abnormalities on examination.

Which of the following is the most likely underlying diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.