A 32-year-old man with a history of ven tricular septal defect presented with systolic and diastolic murmurs and vectocardiogra phic evidence of right ventricular hyper trophy. Echocardiography demonstrated a prominent systolic bulging of the inter- ventricular septum into the right ventricle. Left ventricular angiograms indicated that the ultrasonic abnormality was based on an aneurysm of the membranous septum which produced a 35 mm Hg gradient within the right ventricle. After plication of this aneu rysm, murmur and abnormal septal protru sion were not recorded.
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