![]() The remainder of the physical examination is normal. ![]() A grade 2/6 decrescendo diastolic murmur that increases with inspiration is noted at the left sternal border. The S2 is single, and there is a soft early systolic murmur at the second left intercostal space. The apical impulse is normal there is a parasternal impulse at the left sternal border. The estimated central venous pressure is normal. On physical examination, blood pressure is 110/70 mm Hg, pulse rate is 62/min and regular, and respiration rate is 18/min. She has a history of tetralogy of Fallot with repair performed at the age of 4 years. The episode resolved shortly after arriving at the emergency department. Question 1 CV A 33-year-old woman is evaluated as an outpatient following an episode of atrial fibrillation.
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