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Medicine
A 27 year old man in noted to have blood pressure of 170/100 mmHg. He has prominent aoic ejection click and murmurs heard over the ribs on the both sides anteriorly and over the back posterioly. In addition.the pulses in the lower extremities are feeble and he complains of mild claudication with exeion. The most likely diagnosis is
Aial septal defect
Aoic stenosis
Coarctation of the aoa
Cardiomyopathy
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