A neonate has recurrent attacks of abdominal pain,restless irritability and diaphoresis on feeding. Cardiac auscultation reveals a nonspecific murmur. He is believed to be at risk for M.I. Likely diagnosis here is –
Correct Answer: Anomalous coronary artery
Description: Anomalous origin of coronary arteries
There is anomalous origin of the left coronary artery from the pulmonary artery : In this anomaly the blood supply of the left ventricular myocardium is severely compromised. Soon after birth (Neonate) as the pulmonary arterial pressure falls, perfusion pressure to the left coronary artery becomes inadequate. Myocardial infarction and fibrosis may result.
Clinical manifestion :
Congestive heart failure becomes manifest within first few month of life and is often precipitated by respiratory infection.
Recurrent attacks of discomfot, restlessness, irritability, diaphoresis, dyspnea and pallar with or without cyanosis occur - could be caused by angina pectoris.
Cardiac enlargement is moderate to massive
Murmurs may be present.
Category:
Pediatrics
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