HISTORY: A 5-year-old boy who presented in infancy with cyanosis and dyspnea, later worsened with feeding, crying and walking but improved only by squatting. He developed digital clubbing and had poor growth and delayed development. Cardiac failure never occurred. PHYSICAL EXAMINATION: A precordial bulge, cyanosis, and clubbing were found. A short systolic ejection murmur of moderate intensity was heard at the left sternal border especially in the third and fourth interspaces. Liver and spleen were not enlarged, and no splinter hemorrhages were found. LABORATORY: Hemoglobin 20 gm %, Hematocrit 60%, WBC 9300, normal differential and urine analysis Chest X-ray findings 29 Cardiac Catheterization SITE SVC, IVC RA RV RV Infundibulum PA Aorta OXIMETRY (% SAT) NL NL NL NL Low PRESSURE (mm Hg) NL High High Low NL

Human Anatomy & Physiology (11th Edition)
11th Edition
ISBN:9780134580999
Author:Elaine N. Marieb, Katja N. Hoehn
Publisher:Elaine N. Marieb, Katja N. Hoehn
Chapter1: The Human Body: An Orientation
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HISTORY: A 5-year-old boy who presented in infancy with cyanosis and dyspnea, later
worsened with feeding, crying and walking but improved only by squatting. He
developed digital clubbing and had poor growth and delayed development. Cardiac
failure never occurred.
PHYSICAL EXAMINATION: A precordial bulge, cyanosis, and clubbing were found. A
short systolic ejection murmur of moderate intensity was heard at the left sternal border
especially in the third and fourth interspaces. Liver and spleen were not enlarged, and
no splinter hemorrhages were found.
LABORATORY: Hemoglobin 20 gm %, Hematocrit 60%, WBC 9300, normal differential
and urine analysis
Chest X-ray findings
19
Cardiac Catheterization
OXIMETRY
(% SAT)
ES
NL
NL
NL
NL
Low
SVC, IVC
RA
RV
SITE
RV Infundibulum
PA
Aorta
PRESSURE
(mm Hg)
NL
High
High
Low
NL
1. What are the components of this defect?
2. Identify the borders of the heart on the Chest X-ray
Transcribed Image Text:HISTORY: A 5-year-old boy who presented in infancy with cyanosis and dyspnea, later worsened with feeding, crying and walking but improved only by squatting. He developed digital clubbing and had poor growth and delayed development. Cardiac failure never occurred. PHYSICAL EXAMINATION: A precordial bulge, cyanosis, and clubbing were found. A short systolic ejection murmur of moderate intensity was heard at the left sternal border especially in the third and fourth interspaces. Liver and spleen were not enlarged, and no splinter hemorrhages were found. LABORATORY: Hemoglobin 20 gm %, Hematocrit 60%, WBC 9300, normal differential and urine analysis Chest X-ray findings 19 Cardiac Catheterization OXIMETRY (% SAT) ES NL NL NL NL Low SVC, IVC RA RV SITE RV Infundibulum PA Aorta PRESSURE (mm Hg) NL High High Low NL 1. What are the components of this defect? 2. Identify the borders of the heart on the Chest X-ray
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