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A 71-year-old woman was admitted for examination of a heart murmur and anemia. She had a history of mitral valve replacement and tricuspid ring annuloplasty 8 months prior to admission. A new systolic murmur was heard, and echocardiography showed a high-velocity jet originating from the left ventricular outflow tract to the right atrium and a small defect between the left ventricle and the right atrium...
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