Within 2 hours of birth, a baby girl is obviously cyanotic and chest radiograph shows the heart to appear like “an egg on its side.” The following is/are true:
- The most common cause of cyanosis this early is transposition of the great vessels (TGV)
- If TGV is present, echocardiography will show that the posterior vessel leaving the left ventricle is a pulmonary artery
- If TGV is confirmed by echocardiography, cardiac catheterization has little to add
- The EKG is helpful in making the diagnosis of TGV since it shows reversed dominance of the ventricles
- To improve mixing of pulmonary and systemic circulations, prostaglandin should be used to increase pulmonary vascular resistance
Medicine
a. The most common cause of cyanosis this early is transposition of the great vessels (TGV)
b. If TGV is present, echocardiography will show that the posterior vessel leaving the left ventricle is a pulmonary artery
TGV is the most common cause of cyanosis in the first week of life, and this diagnosis can be confirmed by echocardiographic demonstration of a posterior pulmonary artery attached to the left ventricle. Cardiac catheterization is useful to confirm the anatomy, detect other lesions, define the coronary anatomy and improve cardiac mixing by balloon atrial septostomy. The EKG is not helpful in the diagnosis of TGV since it shows only normal right ventricular dominance. Prostaglandin improves the mixing of the circulation by opening the ductus arteriosus and reducing pulmonary vascular resistance.
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