A 2-day-old male infant born at 38 weeks gestation presents with cyanosis and tachypnea (RR 60/min). On physical examination, blood pressure is significantly lower in the right upper extremity compared to the left, and the right radial pulse is diminished. Pulse oximetry shows SpO2 of 88% on room air that does not improve substantially with supplemental oxygen. Chest X-ray reveals cardiomegaly and mild pulmonary edema. Echocardiography demonstrates a large patent foramen ovale with right-to-left shunting and an unusual aortic arch configuration. Which of the following is the most likely diagnosis?
- A)Coarctation of the aorta with patent ductus arteriosus
- B)Anomalous origin of the right subclavian artery from the descending thoracic aortaGABARITO
- C)Interruption of the aortic arch type B
- D)Transposition of the great arteries with an aberrant right subclavian artery
- E)Tetralogy of Fallot with a vascular ring
Explicação
Anomalous origin of the right subclavian artery (ARSA) from the descending thoracic aorta is a common aortic arch anomaly, particularly associated with trisomy 18 and 22q11 deletion syndrome. The classic presentation includes a diminished right radial pulse an... Ver explicação completa e trilha adaptativa →