Question: A 45-year-old woman with a history of a heart murmur detected in the pediatric age. Enter the Emergency Department for symptoms of palpitations, easy fatigue and malignant edema. Physical examination reveals absence of cyanosis. Oxygen Saturation by pulse oximeter 97%. TA: 120/80 mm Hg. Irregular heart rate at 100 bpm. Systolic ejection murmur (2/6) in pulmonary focus. 2nd R unfolded, wide and fixed. No death rattles. Slight hepatomegaly (2-3 cm). Slight malleolar edema. ECG: complete arrhythmia due to atrial fibrillation at 100 bpm. AQRS: + 120º. Conduction disorder of the right branch of the bundle of His. What is your diagnostic orientation? 
 Options:  <1> Ventricular communication. <2> Aortic stenosis. <3> Mitral stenosis. <4> Interauricular communication. <5> Persistent ductus arteriosus.
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