{"knowledge_schema": {"broad_category": "Medicine \u2192 Cardiology \u2192 Congenital Heart Disease", "refinement": "This case involves a young woman presenting with symptoms and signs suggestive of a structural heart defect, particularly focusing on the heart murmur and associated findings.", "specific_scope": "The clinical presentation includes a systolic ejection murmur, right axis deviation, and signs of right ventricular hypertrophy, which are indicative of specific congenital heart conditions.", "goal": "Identify the most likely cause of the heart murmur based on the clinical presentation and examination findings."}, "summary": "The clinical scenario describes a 31-year-old woman with progressive shortness of breath, a systolic ejection murmur, and signs of right ventricular hypertrophy. The characteristics of the murmur and the patient's history suggest a structural heart defect. Among the options provided, the most likely cause of the murmur is related to a condition that leads to right ventricular outflow obstruction. Given the details, the most appropriate choice is likely to be 'Hypertrophic cardiomyopathy with obstruction,' as it aligns with the symptoms and examination findings."}