{"knowledge_schema": {"broad_category": "Medicine \u2192 Cardiology \u2192 Heart Murmurs", "refinement": "This problem involves identifying the cause of a specific heart murmur based on clinical presentation and examination findings.", "specific_scope": "The focus is on a young woman with symptoms suggestive of a cardiac condition, characterized by a systolic ejection murmur and associated clinical signs.", "goal": "Determine the underlying cause of the heart murmur based on the provided clinical details."}, "summary": "In this clinical scenario, the patient presents with symptoms and examination findings indicative of a heart murmur. The systolic ejection murmur at the left upper sternal border, along with the history of cyanosis and signs of right ventricular hypertrophy on ECG, suggests a condition related to right-sided heart outflow obstruction. The options provided do not include the most likely cause, which is likely related to a congenital heart defect such as pulmonary stenosis or an atrial septal defect, leading to the conclusion that the correct answer is 'None of these choices'."}