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Cas du mois Mai 2021 - Rythmologie-

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Clouds over P waves: what could it be?

A 14- year old boy with neonatal history of cyanosis, was referred to our department for cardiovascular assessment. The boy has been complaining of exertional dyspnea and palpitations.

On physical examination, his Oxygen saturation was 85 % and a systolic heart murmur was present along the left sternal border.

His baseline ECG is the following.

What’s the most likely diagnosis?