Cyanotic 2 months old baby

Tuesday, March 23, 2010
Here shows the Frontal Radiography  of a 2 months old infant  who was brought to the hospital by the mother because this baby had become bluish and difficulty in breathing while mother was bathing the baby.Mother noticed that bluish color was increasing as child cries vigorously.



On examination this baby there was marked central and peripheral cyanosis.But finger clubbing was absent.Baby was tachypnoeic.
His precordial Examination revealed 
  • Bulge  left anterior hemithorax 
  • Systolic thrill is felt along the left sternal border 
  • Loud  systolic murmur most intense at the left sternal border
  • Systolic ejection murmur at the upper sternal border
What are the differential diagnosis of cyanosis??
What are the Abnormalities seen in this Xray??
What  is the Defenetive diagnosis??

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28 comments

  1. Anonymous Says:
  2. fallot tetralogy

     
  3. Anonymous Says:
  4. CONGENITAL cyanotic heart disease
    fallot tetraology

     
  5. Anonymous Says:
  6. tof. boot shape heart

     
  7. Anonymous Says:
  8. I think so.. fallot tetralogy...

     
  9. congenital heart disese, need ECO, can be fallot

     
  10. Anonymous Says:
  11. fallot tetralogy - yea sure, after a few more indepth tests. based on the info given i would have said VSD first and ran some more indepth tests....
    as if a radiograph is enough for a diagnosis..... pffft

     
  12. Anonymous Says:
  13. ah thankx sevda, said exactly what i was thinking. TEE imo

     
  14. Anonymous Says:
  15. needs additional tests, Echo, high likelihood of fallot tetralogy

     
  16. Anonymous Says:
  17. eisenmenger syndrome due to VSD,tetrallogy of fallot,congestive HF due to megacolon which can mean intestinal torsion or intersusception.the megacolon can press VC and cause vc syndrome.
    Blue baby syndrome....
    sound like tetrallogy of fallot

     
  18. Anonymous Says:
  19. arash from iran


    1-DDx includes tricuspid atresia , tetralogy of fallot , sever pulmonary stenosis , transposition of great arteries , truncus arteriosus , total anomalus of pulmonary veins

    2-CXR showed boot shaped heart

    3-TOF

     
  20. Anonymous Says:
  21. arash from iran

    1-DDx includes tricuspid atresia , tetralogy of fallot , sever pulmonary stenosis , transposition of great arteries , truncus arteriosus , total anomalus of pulmonary veins

    in bath baby exposed to warm water , then developed skin vessels dilatation , vascular resistance of systemic circulation decreased , so right to left shant increased and his cyanosis became worsen

    in crying , O2 saturation decreased and cyanosis became worsen

    in defication , valsalva occured , less blood flow went to lung , o2 saturation decreased and cyanosis happened

    children with TOF learn to squatting , in squatting systemic vascular resistance increases and R to L shunt decreases , mixing of saturated and unsaturated blood decreases and their cyanosis will be better

    2-CXR showed boot shaped heart in favor of TOF

    3-TOF

    remember degree of RV outflow obstruction is important , age in which children are symptomatic , depends on degree of pulmonary stenosis , so in sever Pulmonary stenosis after birth baby may be symptomatic or in mild pulmonary stenosis cyanosis may not be seen till adulthood

     
  22. Anonymous Says:
  23. basik
    vsd

     
  24. Anonymous Says:
  25. tetralogy of fallot and large vsd
    boot -shaped heart on cxray

     
  26. Anonymous Says:
  27. fallot tetralogy

     
  28. MWM Says:
  29. DD: Congenital cyanotic heart diseases as vsd with Eisenmenger, Tricuspid Atresia or Fallot (less probably)... or the infant may suffer from severe Respiratory tract infection (bronchiolitis is common at this age)

    The X-ray shows widening of the mediastinum with enlargement of the Pulmonary artery

    From the History .. the problem didn't start at the neonatal period which excludes Tricuspid Atresia ... and from the examination the Difinite Diagnosis would be VSD with pre-Eisenmenger state ( as the cyanosis still not fixed)

     
  30. Anonymous Says:
  31. arah from iran is great

     
  32. Anonymous Says:
  33. arah from iran is great

     
  34. Anonymous Says:
  35. Fallots Tetralogy and coexistent hepatic enlargement

     
  36. Anonymous Says:
  37. x ray show boot shaped heart.
    definitive dx; fallot's tetralogy

    dr. sadia

     
  38. Anonymous Says:
  39. TOF
    Bootshape heart
    Transposition of great arteries
    CTR Increasing
    Scoliosis
    Dilatation of Proximal intestinal

     
  40. ris system Says:
  41. Hey there, this is an awesome radiology software program. Check it out!
    
Radiology Software
    Let me know what you think.

     
  42. Anonymous Says:
  43. vsd
    tof

     
  44. Anonymous Says:
  45. DD/tetralogi of fallot; transpotition great of aorta
    boot-shaped heart on the x-ray
    we must be performed echo but it's should be tetralogy of fallot

     
  46. 1-DD/tetrology of fallot,tricuspid atresia,Ebstein anomaly,single ventricle,Total anomalous Pulmonary venous return,Hypoplastic left heart sydrome
    N.B.TGA Also causes cyanosis but it's The baby is born cyanosed
    2-CXR shows enlargement of left ventricle , Decreased bronchovascular markings and prominant plumonary artery -boot shaped heart-
    3-The defentive diagnosis is Congential cyanotic heart disease - Tetrology of fallot

     
  47. Anonymous Says:
  48. the deffinit Dx is ToF

     
  49. Anonymous Says:
  50. A-Differential diagnosis are:
    1- Cyanotic congenital heart diseases
    a- Teratollogy of fallot
    b- Transposition of great vesseles.
    c- Single ventricle.
    d- Other.
    2- Pulmonary disease.
    3- CNS disease.
    B- chest Xray show enlarged cardiac shadow, wide medastinum(Boat heart shape).
    C- The diagnosis is TERATOLLOGY OF FALLOT.

    dr_islam farouk_ sudan
    dr_islam77@live.com

     
  51. Anonymous Says:
  52. what about dilatation of transversal part of the colon?

     
  53. Anonymous Says:
  54. fallot tetralogy

     

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