Atrial Septal Defect (ASD) and Pulmonic Stenosis (PS)

ASD (Atrial Septal Defect) and PS (Pulmonic Stenosis): CKCS, 1,5 years, weight loss, syncope, lethargy. Systolic heart murmur left and right heart base ~ 4/6 intensity inconstant (wich goes with inconstant v-max on spectral). Severe type B PS (severe hypoplasia of PV). Additionally small bidirectional Type 2 ASD. (seen on right parasternal 4 chamber long axis as well as on short axis views of the heart base) R-L component of this bidirectional shunt was confirmed by bubbles )not seen). Severe RV hypertrophy, small femoral pulse wave. On ECG right axis deviation. Treated first with Atenolol then went on to surgery.