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Images in neonatal medicine
Bedside agitated saline test confirming diagnosis of anomalous right superior caval vein draining into the left atrium
  1. Nishanti Han Ying Wijedasa1,
  2. Marielle Valerie Fortier2,
  3. Dyan Zhewei Zhang3,
  4. Sharon Ann Aquino-Grino1,
  5. Jonathan Tze Liang Choo3
  1. 1Department of Neonatology, KK Women's and Children's Hospital, Singapore
  2. 2Department of Diagnostic and Interventional Imaging, KK Women's and Children's Hospital, Singapore
  3. 3Department of Paediatric Subspecialities, KK Women's and Children's Hospital, Singapore
  1. Correspondence to Dr Jonathan Tze Liang Choo, Department of Paediatric Subspecialities, KK Women's and Children's Hospital, 229899, Singapore; chooseml{at}yahoo.com.sg

https://doi.org/10.1136/archdischild-2020-319737

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    Cardiology was called to review a neonate with cyanosis at 6 hours of life. The oxygen saturations averaged 70% at baseline with no preductal and postductal difference. No cardiac murmurs were heard, but the chest X-ray showed an enlarged heart. Transthoracic echocardiography (TTE) demonstrated a small patent arterial duct and a patent oval foramen, both with left-to-right flow across. TTE also showed dilatation of the left atrium (LA) and left ventricle (LV) (figure 1A), suggesting increased flow to the left—heart (figure 1B). The atrioventricular and ventriculoarterial connections were normal.

    Figure 1

    Image panel outlining the diagnostic approach to the echocardiographic evaluation of the patient. …

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    Footnotes

    • Contributors NHYW wrote the manuscript. MVF performed the CT scan and critically reviewed the manuscript and images. DZZ critically reviewed the manuscript and images. SAA-G wrote the manuscript with NHYW. JTLC performed the echocardiogram and critically reviewed the manuscript and images.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; internally peer reviewed.