Case 297 Medical history RNT, male, has been diagnose with a congenital heart disease at 27 weeks, in an obstetric US. He was born well, Apgar 8/8, but has presented hypoxemia and was referred to neonatal ICU, using prostaglandin E1 (PGE1). After an improvement, he tolerated PGE1 interruption and has been referred to service of Pediatric Cardiology of HC-UFMG, at 10 days of life, for outpatient follow-up. Keep cyanosis, but with no failure to breastfeeding. At cardiac auscultation presents regular rhythm with a loud S2, systolic regurgitative murmur audible over the whole precordium with radiation to the back. EKG at the age of 2 months: sinus rhythm and QRS axis deviation to the left with suggestive signs of left ventricular overload. Doppler echocardiogram presented: Transthoracic doppler echocardiography showing atrial shape and contents.Transthoracic doppler echocardiography showing right atrial (AD) shape and contents, descending aorta (AO) and ventricles (VD- right and VE- left).Transthoracic doppler echocardiography showing ventricular shape and contents.Transthoracic doppler echocardiography; Apex view of the ventricular chambers.transtorácico; corte apical de câmaras ventriculares. Question:Based on the echocardiogram images provided and the clinical history, which diagnosis is the most likely? a) Tetralogy of Fallot b) Pulmonary atresia with VSD c) Hypoplastic Right Heart Syndrome d) Ebstein's anomaly Test question Question:(UNIFESP – R3 Pediatric Cardiology – 2014) In newborns with congenital heart disease with univentricular heart physiology. Considering the surgery approach, mark the correct alternative: a) The primary treatment of the heart disease (total correction) should be done after the decrease of pulmonary resistance. b) Initially it must extend or create a ASD to provide a satisfactory shunt and blood mix. c) The birectional Glenn's surgery is indicated in the first 2 months of life d) In the univentricular heart, anatomical details and physiological parameters have little interference in the surgery approach. e) It has as aim ensure the adequate anatomy and physiology for the surgery with the Fontan’s physiology, that is, in cases with diminished pulmonary flow provides the Blalock-Taussig’s shunt (systemic-pulmonary shunt) and in cases with increased flow, execute the pulmonary artery banding. Time is Up! Time's up
