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April 1991

Radiological Case of the Month

Author Affiliations

Contributed from the Departments of Radiology, University of Arkansas for Medical Sciences (Drs Allison and Angtuaco) and Arkansas Children's Hospital (Drs Stephenson and Glasier), Little Rock.

Am J Dis Child. 1991;145(4):471-472. doi:10.1001/archpedi.1991.02160040133022

A fetal cardiac abnormality was detected in a prenatal ultrasound examination of a 31-year-old woman. No family history of genetic syndromes or congenital heart disease was elicited, and she had two normal children. The infant, delivered by spontaneous vaginal delivery at 36 weeks' gestation, developed respiratory distress shortly after birth and was intubated.

Physical examination revealed afebrile, cyanotic female infant with tachycardia (heart rate, 116 to 152 beats per minute) and tachypnea (48 to 76 breaths per minute).

Hypopigmented macules were present on her back and buttocks. The liver was palpable 3 cm below the costal margin.

An electrocardiogram revealed Wolff-Parkinson-White complex, biventricular hypertrophy, and atrial enlargement. Laboratory values were unremarkable except for hypoxia. A chest roentgenogram (Fig 1), echocardiogram, cardiac magnetic resonance imaging (MRI) (Fig 2), and cranial computed tomography (CT) (Fig 3) and MRI (Fig 4) were performed during diagnostic workup.

The infant's congestive heart failure was treated

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