A 3-week-old male infant was seen for routine evaluation. His parents reported no problems other than decreased feeding for 4 to 5 days. The infant was mildly pale and tachypneic. His weight was 3700 g (60 g above birth weight). Respirations were 70/min. There was a grade 2/4 systolic ejection murmur at the upper left sternal border. Pulses were normal. He was referred for further diagnostic studies, including a chest roentgenogram (Fig 1), an echocardiogram (Fig 2), magnetic resonance imaging (Fig 3), and angiography (Fig 4).
Denouement and Discussion
Anomalous Origin of the Right Pulmonary Artery From the Aorta: 'Hemitruncus'
Hemitruncus is an unusual cardiovascular malformation in which one pulmonary artery, usually the right,1 arises from the ascending aorta, while the opposite pulmonary artery connects normally to the main pulmonary trunk. An associated patent ductus arteriosus is common,2 and intracardiac defects are occasionally present.1,2 The diagnosis must be applied cautiously to avoid confusion with
Gumbiner CH, Cheatham JP, Latson LA, Danford DA, Kugler JD, Hofschire PJ, Wood BP. Radiological Cases of the Month. Am J Dis Child. 1989;143(10):1209–1210. doi:10.1001/archpedi.1989.02150220109029