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.