Cyanotic congenital heart defects Quiz: Ace Your Exams

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A 3-day-old female infant is brought to the emergency department due to difficulty breathing. She was born at term through normal vaginal delivery to a 30-year-old woman who had full prenatal care. The mother reports that the patient was fine after birth and recently started developing blue-colored skin and rapid breathing at home. Temperature is 37°C (98.6°F), pulse is 155/min, respirations are 65/min, and blood pressure is 80/50 mm Hg. Pulse oximetry shows an oxygen saturation of 80% on room air. Arterial blood gas analysis on room air shows PO2 of 30 mm Hg. Physical examination shows central cyanosis and retractions of the rib cage. 100% oxygen through a nasal cannula and PGE1 are administered. The patient’s airway is stable, and a chest radiograph is obtained (shown below). Which of the following is the most likely diagnosis?  

A chest X-ray shows the lungs, heart, and rib cage of an adult. The image has a standard black and white radiography view, with no obvious anomalies.A lateral X-ray shows the human chest and upper abdomen from the side, revealing ribs, spinal bones, and lung fields.
Reproduced from: Radiopaedia 

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