Heart murmur causes. Most heart murmurs are caused by blood flowing through healthy valves in a healthy heart and do not require treatment. However, heart murmurs can be caused by blood flowing through a damaged or overworked heart valve. Heart valve defects may be present at birth or may result from other diseases, such as rheumatic fever, heart disease, heart attacks or infective endocarditis.
Hi! You can use estudiosa. Or trabajadora is a good one too, though it is slightly different. It means hard-working.. Other good adjectives which are along this line, though not exactly interchangeable would be Inteligente = intelligent; lista = clever.
Best Answer: Muy bien is the proper way. Bueno is the superlative, that is, you cannot be better than bueno, that is the extreme. So, placing muy at the start of bueno is redundant. Plus it sounds weird. An example in English could be the use of the word Excellent - that word already tells you that the person is excelling, ex meaning further, or outer.