The patient is an 8-month-old girl who presents with a chronic cough for the last four months following an episode of hospitalization for bronchiolitis. The patient also has breathing difficulties whenever stressed by illness. The presence of a heart murmur was first noted on the second day of life, and the patient had a single cyanotic episode one month ago. On physical exam, the patient was noted to have scattered crackles in all lung fields and a 3/6 blowing holosystolic and diastolic murmur.
: Although there are no prior studies for comparison, there is significantly increased pulmonary vascular markings when compared to the normal 8-month-old. There is also an enlarged cardiomediastinal silhouette. Osseous structures demonstrate a twelfth hypoplastic rib on the left.
Single ventricle and hypoplastic left heart demonstrate significant cardiomegaly. Transposition has a narrow aortic knob area
Dx: Congestive heart failure secondary to an endocardial cushion defect
Dx Confirmed by:
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