Dr. Dale E. Wenlund: A 5-day-old baby boy was referred to this hospital because of congestive failure. The child had been born of a normal full-term pregnancy. There had been a short labor of only one hour and a normal delivery. Initially, he did well but on the fifth day, developed respiratory distress. A diagnosis of congestive failure was made at that time. It was noted that the infant was not cyanotic but had a respiratory rate of 140 per minute and a normal temperature level.
On admission to the hospital, he was in respiratory distress but did not appear to be moribund. The blood pressure was thought to be about 60 mm Hg in both the arms and the legs, although this was difficult to determine. The heart beat was in a gallop rhythm at a rate of 140 beats per minute. There was a grade I systolic murmur