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[Imaging in cardiology].

A 28-year-old female was referred to the cardiology outpatient department by her general practitioner because ofcomplaints ofprogressive atypical chest pain and the presence of a cardiac murmur on physical examination. She did not experience symptoms of heart failure, there were no risk factors for cardiovascular disease, and she had no history of previous rheumatic fever or chest trauma. On physical examination the patient did not appear acutely or chronically ill. She was normotensive with a normal pulse pressure and a normal central venous pressure, afebrile and there were no stigmata of bacterial endocarditis. On palpation a precordial thrill was present, and on auscultation a continuous murmur was heard with maximal intensity over the apex. Additional laboratory investigations were normal. Transthoracic colour Doppler-echocardiography revealed continuous turbulence at the apex ofthe right ventricle, without the presence of right ventricular dilation or pulmonary hypertension.