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Unusual angiographic pattern of a muscular ventricular septal defect.

The case of a 13-year-old boy with a well tolerated ventricular septal defect is reported. It is of particular interest because of the unusual angiographic appearances. C.B., a 13-year-old boy, had been known to have a systolic heart murmur for several years. He had had no symptoms until one year before investigation, when he developed dyspnoea on effort. There was no history of serious illness and in particular none of rheumatic fever. He was well developed, being 1·43 m in height and weighing 33·200 kg. The lower part of the sternum was slightly depressed. The arterial blood pressure was 110– 60 mm Hg. A short harsh mid-systolic murmur grade 4/6 intensity was heard best medial to the cardiac apex and in the left axillary area.