6year old child with history of 6month cough .on exertion profuse sweating.throat pain for 3days.tiredness
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Prominent pulmonary conus suggest LAH secondary to valvular heart disease or recurrent streptococcal infection in f endocardium needs further workout like 2-D Echo ECG and blood C&S Probable treatment may be valvotomy or replacement or to put on long acting penicillin after assessment !!