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The disappearance of a ventricular septal defect (VSD) murmur in a patient known to have a large left-to-right shunt is most likely due to

1) development of aortic stenosis.

2) closure of ventricular septal defect (VSD).

3) increase in the left-to-right shunt.

4) development of pulmonary stenosis.

5) development of significant pulmonary arterial hypertension.


5- dev of significant pulmonary HTN ?




Agree with 5




yes, 5. equalization of pressures on the right and left side. will lead to Eisenmenger syndrome ie rt to left shunt if left untreated


with complete eisenmenger and rt-lt shunt will any murmur be heard?


eisenmanger 5.


with equalization of pressure there will be no murmer. when right sided pressures increase more than left sided, there would be a rt to right shunt and a murmur would be heard again.



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