Adult Patient With Systolic Murmur: An Unexpected Diagnosis of Congenital Heart Disease.

We present a case of a 50-year-old male patient with shortness of breath and progressive edema. Echocardiography demonstrated dilation of the four cavities, left ventricular dysfunction, and a patent arterial duct (PDA) with systolic predominant flow due to pulmonary hypertension. Cardiac magnetic resonance imaging (MRI) confirmed the PDA. This case is of particular interest since the typical continuous heart murmur found in PDA is lost due to equalization of the diastolic pressure between the pulmonary and aortic circulation.