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  #1  
Old 07-06-2011
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X Ray Newborn boy with cyanosis and this Chest X ray

A newborn baby boy is admitted to NICU for blue lips, skin and nails. He has sob while eating . On examination he has a loud SEM,a loud single S2, a thrill with a wide pulse pressure, hyperdynamic precordium with bounding pulses. His chest x-ray reveals the following :

Newborn boy with cyanosis and this Chest X ray-images.jpeg
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Which of the following is the most likely diagnosis?

A. TOF
B. d-TGA
C. Severe Epstein Anomaly
D. Hypopastic left heart
E. TAPVR
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  #2  
Old 07-06-2011
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the picture similar to truncus arteriosus
but not within answers

B. -TGA the answer

single S2 causes is TGA-TOF-truncus arteriosus
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  #3  
Old 07-06-2011
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iwant the answer plz this q confused me really
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Old 07-06-2011
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wide pulse pressure is seen in PDA..but its not mentioned in options...i think its TOF ...
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Old 07-06-2011
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i think its TGA.
please post the answer!
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  #6  
Old 07-06-2011
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Hi,

Check : http://radiographics.rsna.org/conten...323.full#sec-4

:-)
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  #7  
Old 07-06-2011
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The answer is E. TAPVR and more precisely it is the non-obstructive type which presents on a x-ray with an enlarged heart with pulmonary edema and when the veins enter the SVC there is a "snowman appereance" also called "figure of eight or cottage loaf".
If the TAPVR ere obstructive type , on chest x ray there would be a small heart with pulmonary venous congestion and usually babies w obstructive type would need immediate surgery. Prostaglandins don t work like they do in TAPVR non-obstructive type.
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