Dr. Joseph H. Lyons: An 18-day-old baby girl was admitted to the hospital for evaluation of apparent congenital heart disease. The child followed an unremarkable pregnancy and delivery and she was cyanotic on the second day of life. On physical examination there was frank cyanosis but no real respiratory distress. A systolic murmur was heard by some examiners, but not confirmed by the cardiac consultant. An electrocardiogram demonstrated left axis deviation. These roentgenograms of the chest were obtained on the infant's admission to the hospital (Fig 1).
Dr. Laurence L. Robbins: Dr. Weber, do you want to talk about this?Dr. Alfred L. Weber: In the analysis of this case, I will first describe the roentgenograms of the chest and will try to correlate these with the history, the physical findings, and the electrocardiogram.It is quite obvious that the heart shadow is enlarged with a considerable bulge to