Figure 1 X-ray chest Postero-anterior (PA) view at 2 months of
age reported as right upper zone pneumonia.
The child was kept on low-flow oxygen and an empirical antibiotic was
started. The septic screen was unremarkable and the blood culture was
sterile. A faint murmur was appreciated at the left parasternal region
with loud S2.2D Echocardiography revealed large perimembranous VSD with
moderate PDA and severe Pulmonary Artery Hypertension (PAH).
Anti-failure medications (Furosemide and spironolactone) were started,
and definitive repair was planned after sufficient weight gain. Oxygen
was weaned off and child was discharged after 7 days.
On regular subsequent follow-ups, the child persisted to have cough and
tachypnea, as well growth failure was also reported. Thus, definite
cardiac surgery was performed at 3 months and 7 days of age.The baby
underwent Glutaraldehyde treated Pericardial Patch Closure of
Ventricular Septal Defect with Patent Ductus Arteriosus Ligation. The
surgical procedure was uneventful.
Even after the definitive cardiac surgery, the child continued to have
cough, tachypnea, occasional retraction, and growth failure. Repeated
evaluations ruled out the presence of infection or congestive cardiac
failure (CCF). Repeated Echocardiography affirms the success of the
cardiac repair. Then after, the child had lost follow-up for almost 3
months.