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?

  1. A)Coarctation of the aorta with patent ductus arteriosus
  2. B)Anomalous origin of the right subclavian artery from the descending thoracic aortaGABARITO
  3. C)Interruption of the aortic arch type B
  4. D)Transposition of the great arteries with an aberrant right subclavian artery
  5. 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 →

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