A 4-day-old baby presented with a 3-hour history of respiratory distress and distal acrocyanosis. Physical examination: Hypotensive A murmuring sound in the heart General state: Uncomfortable and pallor, along with tachypnea, subcoastal retractions, and perioral cyanosis Cardiac auscultation: A grade I/VI systolic murmurs at left sternal border Liver: Palpable and 2 cm below the costal margin Hypoactive and hypotonic Laboratory examination: Moderate liver function (AST 62U/L, ALT 118U/L, and CRP 15.3mg/L) Elevated cardiac enzymes (troponin T: 4,046ng/L, proBNP >35,000 pg) D-dimer: 1.621 ng/mL Radiological examination: Chest X-ray: Cardiomegaly without pleural effusion Echocardiogram: Left ventricular dysfunction (EF 45%), thrombus in the left atrium, and pulmonary hypertension Electrocardiogram (ECG): a QS pattern in leads I, aVL, and V6 Fig.
1. Electrocardiogram (ECG) depicting a QS…
