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The holosystolic quality of the murmur suggests a regurgitant murmur of either the mitral or tricuspid valve. The normal venous contour and pressure, the lack of a pulsatile liver, and the abnormality of the left ventricular impulse all make a left-sided murmur more likely. A VSD or ASD are possible, but the normal quality and splitting of the second heard sound make these … ................
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