ABSTRACT
A 16-year-old male, ORIF non-union of (R) medial epicondlye. He had no significant past medical history and his physical exam was essentially negative. He sustained the initial injury playing basketball. He was monitored with standard ASA monitors and induced width 1mg Midazolam 100macro grams Fentanyl and 250 mg Sodium Penthol. Endotracheal intubation was performed under relaxation using 50 mg Atracrium. Anesthesia was maintained with nitrous oxide, oxygen and Isoflourane changing to Desflurane at the end of the procedure, when he extubated and transferred to PACU where vital signs were stable but he had a harsh pan systolic murmur. On discharge from PACU, he was admitted and a Pediatric Cardiology consultation was requested. At 10:00p.m., six hours post-op the murmur was no longer heardand he remained asymptomatic. Our differential diagnosis was MVP IHSS and flow murmurs(AU)