A 24-Year-Old Man Is Evaluated for Fatigue and Palpitations

A 24-year-old man is evaluated for fatigue and palpitations.  He reports good exercise tolerance with only mild dyspnea on exertion.  Electrocardiogram shows normal sinus rhythm with a right bundle branch block.  Right and left cardiac catheterization is obtained and the following blood oxygen saturation values are reported: Which of the following is the most likely physical examination finding in this patient?

A) Brachial-to-femoral pulse delay
B) Continuous murmur at the left sternal border
C) Digital clubbing
D) Fixed splitting of S2
E) Holosystolic murmur at the left sternal border

Correct Answer:

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