An 11-day-old neonate presented with difficulty in breathing, poor feeding and sweating during feeding. O/E Weak femoral pulse Radial pulse -bounding Radio-femoral delay Loud S2 Systolic ejection clicks or thrill in the suprasternal notch Sho systolic murmur was heard along the left sternal border at the 3rd and 4th intercostal spaces transmitting to the left infrascapular area and to the neck. ABG of lower limbs revealed severe acidosis as compared to the upper limbs. SpO2 (upper limb)> SpO2 (lower limb) Chest X-ray Which of the following needs to be given urgently to the neonate to save the life of the neonate: -
High-Yield Explanation
This is a case of Coarctation of aoa in a neonate Coarctation of aoa: - Males > females May be a feature of turner syndrome Occurs just below origin of left subclan aery Classic sign is disparity in pulsation and blood pressure in the arms and legs. Differential cyanosis if diagnosed before ductal closure. Closure of the ductus often results in hypoperfusion, acidosis, and rapid deterioration. Infusion of prostaglandin E1reopens the ductus and re-establish adequate lower extremity blood flow.