Due to difficulty breathing and sweating with feeds, a 10-day-old boy born at home is brought to the emergency department. He was born via spontaneous vaginal delivery at 38 weeks gestation. The patient has been breastfeeding for 5-10 minutes per side every 2 hours. His mother notices that he sweats while feeding and that his lips turn blue. Weight is in the fifth percentile, and length is in the fifty-fifth percentile. The patient is not currently cyanotic, according to the examination. A III/VI systolic crescendo-decrescendo murmur can be heard along the left upper sternum. The x-ray of the chest is shown below. : Which of the following most likely represents the pressure changes that take place in this patient during feedings?

Question

Due to difficulty breathing and sweating with feeds, a 10-day-old boy born at home is brought to the emergency department. He was born via spontaneous vaginal delivery at 38 weeks gestation. The patient has been breastfeeding for 5-10 minutes per side every 2 hours. His mother notices that he sweats while feeding and that his lips turn blue. Weight is in the fifth percentile, and length is in the fifty-fifth percentile. The patient is not currently cyanotic, according to the examination. A III/VI systolic crescendo-decrescendo murmur can be heard along the left upper sternum. The x-ray of the chest is shown below. :  Which of the following most likely represents the pressure changes that take place in this patient during feedings?

Quizplus · Accepted Answer

Eductional Objective: The major defects in tetralogy of Fallot are an obstruction of the right ventricular outflow tract (RVOT) and a ventricular septal defect (VSD). Many patients experience cyanotic episodes (tet episodes) as a result of activities that cause a dynamic increase in RVOT obstruction. During these episodes, right ventricular pressure rises while pulmonary arterial and left atrial pressures fall as blood is diverted from the pulmonary circulation (ie, right-to-left shunting through the VSD).

Due to Difficulty Breathing and Sweating with Feeds, a 10-Day-Old