MedPix® Patient Chart - Case No: 3944 :: Imaging - Review Images

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History

Age: 1 :: Gender: girl

Patient History

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.

Exam


Physical Exam and Laboratory


Imaging

Imaging - Review Images for PT: 3944

Findings


Summary of Findings

: 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.


Imaging

Imaging - Review Images for PT: 3944

Diffferential


Differential Diagnosis

Single ventricle and hypoplastic left heart demonstrate significant cardiomegaly. Transposition has a narrow aortic knob area


Imaging

Imaging - Review Images for PT: 3944

Diagnosis


Case Diagnosis

Dx: Congestive heart failure secondary to an endocardial cushion defect


Dx Confirmed by:



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History:
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.

Exam:


Findings:
: 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.

Differential:
Single ventricle and hypoplastic left heart demonstrate significant cardiomegaly. Transposition has a narrow aortic knob area

Diagnosis:
Congestive heart failure secondary to an endocardial cushion defect
Confirmed by:

Treatment and Followup:


Discussion:

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Case Contributor and Editor
Submitted by: MS-4 USU Teaching File - Author Info
Case/Image Editor: Greg Petermann - Editor Info
Case Accepted: :: Revised: :: Submitted:
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