Clinical Presentation of Congenital Heart Disease in the First Week of Life: Cyanosis

You are called to evaluate a newborn male patient who appears “blue”. His O₂ saturation is 70% on room air. An x-ray of his chest demonstrates increased pulmonary vasculature. You perform an echocardiogram and note that the right ventricle pumps blood directly into the aorta in the absence of a VSD. Which of the following conditions does the patient have?

A 2-day-old infant is noted to have persistent cyanosis. The pregnancy was unremarkable, but the mother has a history of bipolar disorder and has been taking lithium throughout her pregnancy. The birth was uncomplicated.  On exam, his O₂ saturation is 65%. You obtain a chest x-ray which demonstrates an unusually large heart. Which of the following is the most likely diagnosis?

You are called to the neonatal intensive care unit to evaluate a 2-day old baby born at 28 weeks gestation via emergent C-section for preterm labor and fetal distress for respiratory distress. The baby has a respiratory rate of 80 breaths per minute with moderate subcostal and intercostal retractions. He is requiring CPAP to maintain adequate ventilation and oxygenation. A chest x-ray shows a diffuse pattern consistent with fluid-filled alveoli. Which of the following is the MOST likely diagnosis of this baby’s condition?

You are evaluating a 2-day-old term neonate in the newborn nursery who is hypoxemic. The chest x-ray is unrevealing.  The ECG reveals normal sinus rhythm with a superior axis and left ventricular hypertrophy. Which of the following congenital heart disease lesions is MOST consistent with these ECG findings?

You are evaluating a newborn infant with a prenatal diagnosis of Tetralogy of Fallot with pulmonary stenosis. His ECG confirms right ventricular hypertrophy and his chest x-ray shows decreased pulmonary blood flow. What type of murmur would you expect to hear on cardiac auscultation?

You perform an echocardiogram on a hypoxemic newborn infant and diagnose right-to-left shunting at the atrial level.  Chest radiograph shows normal heart size. Which of the following diagnoses is MOST likely?

You are caring for a hypoxemic neonate who has an echocardiogram which reveals that blood flow to the pulmonary arteries largely is supplied by the ductus arteriosus as opposed to from the right ventricle. The right ventricle appears hypertrophied and the aortic inlet is overriding the ventricular septum. There is a ventricular septal defect present. Which of the following congenital cardiac lesions are these echocardiogram findings consistent with?

Which of the following BEST distinguishes between pulmonary stenosis and pulmonary atresia with intact ventricular septum?

Which of the following congenital heart lesions will have a normal oxygen saturation?