Approach to congenital heart diseases (cyanotic) Quiz: Ace Your Exams
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A newborn boy delivered at 38 weeks gestation is found to be in respiratory distress 4 hours after delivery. The pregnancy and delivery were without complications. APGAR scores were 5 and 7 respectively, at 1 and 5 minutes. Temperature is 36.8�C (98.2�F), heart rate is 210/min, respiratory rate is 60/min, blood pressure is 60/30 mmHg, and oxygen saturation is 82% on room air. On physical examination, the skin is gray, cool, and mottled, there is central cyanosis and subcostal retractions are observed. Pulmonary exam is within normal limits. Cardiac examination is significant for a single loud S2 without murmur. There are weak peripheral pulses bilaterally. The newborn is intubated and placed on mechanical ventilation and an umbilical line is inserted for intravenous fluids. Chest X-ray shows cardiomegaly and pulmonary venous congestion. An echocardiogram reveals a hypoplastic left atrium and ventricle. Which of the following is the best next step in management?
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