Dr. J. Sawalla Guseh II: A 54-year-old male athlete was evaluated in the cardiovascular performance program clinic of this hospital because of progressive exertional dyspnea and chest pain.

and right atrial hypertrophy and left ventricular hypertrophy. Chest X-ray may show increased or decreased pulmonary blood flow depending on the shunt. In addition, we found congenital scoliosis ...