A 25 year old male is diagnosed to have ASD. On examination, a murmur similar to MR is heard and his ECG is showing left axis detion of 40 degrees. What is he most likely suffering from ?

The murmur is the clinching point here as the patient is having ostium primum type of ASD with MR. Ostium primum defect alone cannot produce such a murmur and in the question it is already mentioned that the patient is having ASD, so Floppy mitral valve should be the answer. "Presence of pansystolic murmur of mitral regurgitation (MR) in a patient with ASD suggests the presence of ostium primum defect with cleft in mitral leaflet or floppy mitral valve with mitral valve prolapsed" "ECG shows right axis detion in ostium secundum ASD and extreme left axis detion in ostium primum ASD". "Clinical presentation of ostium primum is similar to ostium secundum except that there may be a mitral systolic murmur due to MR and ECG shows left axis detion"