Anomalous origin of the left pulmonary artery (original) (raw)

IMAGE IN CARDIOLOGY A 4-year-old girl presented to our hospital with a diagnosis of a subpulmonic ventricular septal defect. It was reported that she had been markedly symptomatic from early infancy with failure to thrive, recurrent lower respiratory tract infection and interruption of breast feeding. She was on furosemide 20mg and spironolactone 6.25mg orally once a day. On physical examination her weight was 14.5kg and her height was 93cm. Her blood pressure was 104/51mmHg in the left arm. No cyanosis was noted. Her chest was clear with good air entry. Her precordium was active and bulging with the apical impulse displaced downward and laterally. She had a pansystolic murmur of 3/6 best heard over the left lower sternal border. The liver was palpable 3cm below the right coastal margin. She had a trace of pedal edema. Her hematocrit was 37.6%. Other hematologic profiles were also within normal limits. The electrocardiogram (EKG) showed sinus rhythm at 108bpm and no remarkable abnor...