Caso 3/2008: lactente de 14 meses, do sexo feminino, com fístula arteriovenosa pulmonar

Abstract

Clinical dataCyanosis as an isolated sign appeared at 5 months of age, having recently progressed accompanied by an infectious process. Physical examinationPatient was eupneic, with marked cyanosis, and pulses were palpated normally on all 4 limbs. Weight: 10 Kg, Height: 81 cm, BP: 90/60 mm Hg, HR: 120 bpm. O2 saturation, at rest: 50%. Aorta was not palpable at the supraesternal notch.There were no deformities or impulsions in the precordium. Ictus cordis was not palpated. Heart sounds were normal and no heart murmurs were identified.Lung auscultation evidenced a slight difference in characteristics [timbre] of vesicular breath sounds from one side to the other of the chest. The abdomen showed no abnormalities.The electrocardiogram showed sinus rhythm and signs of left ventricular chamber overload with deep S waves in V2 and V3 (Sokolof Index: 40 mm) with ÂQRS: +100o, ÂP: +60o, and ÂT: +30o. Radiographic imagecardiac area with slightly increased dimensions, elongated and rounded left ventricular arch, and normal pulmonary vascular network (rete). A hypotransparent image with