A 3-week-old female newborn is brought to the emergency department because of a 4-day history of bluish discoloration of the feet, poor feeding, excessive sweating, and irritability. She was born at term following an uncomplicated pregnancy and spontaneous vaginal delivery. Examination following delivery showed no abnormalities and she was discharged two days later. She is exclusively breastfed. She appears ill. She is at the 70th percentile for length and 20:h percentile for weight. Her temperature is 36.8°C (98.2°F), pulse is 168/min, and respirations are 66/min. Her blood pressure is 91/69 mm Hg in the right arm, 90/70 mm Hg in the left arm, 72/67 mm Hg in the right lower limb, and 70/68 mm Hg in the left lower limb. Pulse oximetry on room air shows an oxygen saturation of 98% in the right hand and 78% in the right foot. On examination, subcostal retractions are seen, and the liver is palpated 4 cm below the right costal margin. Chest auscultation discloses fine crepitations in both lung fields and a grade 3/6 systolic murmur heard best at the left paravertebral interscapular area. Which of the following is the most likely explanation for this patient's symptoms? Caudal displacement of the tricuspid valve Narrowing of the ascending aorta at the sinotubular junction Narrowing of the descending aorta near the ligamentum arteriosum Failure of the aorticopulmonary septum to form. Anterosuperior displacement of the infundibular septum
A 3-week-old female newborn is brought to the emergency department because of a 4-day history of bluish discoloration of the feet, poor feeding, excessive sweating, and irritability. She was born at term following an uncomplicated pregnancy and spontaneous vaginal delivery. Examination following delivery showed no abnormalities and she was discharged two days later. She is exclusively breastfed. She appears ill. She is at the 70th percentile for length and 20:h percentile for weight. Her temperature is 36.8°C (98.2°F), pulse is 168/min, and respirations are 66/min. Her blood pressure is 91/69 mm Hg in the right arm, 90/70 mm Hg in the left arm, 72/67 mm Hg in the right lower limb, and 70/68 mm Hg in the left lower limb. Pulse oximetry on room air shows an oxygen saturation of 98% in the right hand and 78% in the right foot. On examination, subcostal retractions are seen, and the liver is palpated 4 cm below the right costal margin. Chest auscultation discloses fine crepitations in both lung fields and a grade 3/6 systolic murmur heard best at the left paravertebral interscapular area. Which of the following is the most likely explanation for this patient's symptoms?
- Caudal displacement of the tricuspid valve
- Narrowing of the ascending aorta at the sinotubular junction
- Narrowing of the descending aorta near the ligamentum arteriosum
- Failure of the aorticopulmonary septum to form.
- Anterosuperior displacement of the infundibular septum
AI-generated content may present inaccurate or offensive content that does not represent bartleby’s views.
Unlock instant AI solutions
Tap the button
to generate a solution
