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This 18-year-old, healthy-appearing, asymptomatic woman had cyanotic nailbeds.

133. congenital cyanotic heart disease

Digital clubbing with cyanotic nail beds in an otherwise healthy-appearing, asymptomatic young adult is characteristic of acongenital cardiac anomaly with right-to-left shunting. The patient shown had tetralogy of Fallot, the most common congenital cyanotic heart disease inadults.

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Source:  OpenStax, Images of memorable cases: 50 years at the bedside. OpenStax CNX. Dec 08, 2008 Download for free at http://cnx.org/content/col10449/1.7
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