PMC7341379_01
Clinical appearance of the patient during primary care showing marked differential cyanosis.
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Throughout primary care, the patient presented with marked differential cyanosis, leaving the right arm and right quadrant of the chest pink with SaO2 measured 100% at the right arm, while the rest of the body appeared cyanotic with SaO2 levels of 75% (Figure 1).
Echocardiography of the newborn with B-image on the left and a simultaneous color Doppler on the right; in a high right parasternal long axis, an aberrant origin of the right subclavian artery (RSCA) from the right pulmonary artery (RPA) could be displayed with course towards the right arm. RIV, right innominate artery.
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However, an anomalous artery could be displayed in multiple views originating from the right pulmonary artery (RPA) with course between the superior vena cava and aorta towards the right arm (Figure 2).
Schematic illustration of a d-transposition of the great arteries (D-TGA) in combination with an aberrant origin of the right subclavian artery (RSCA) from the right pulmonary artery (RPA). IVC, inferior vena cava; LA, left atrium; LCA, left carotid artery; LPA, left pulmonary artery; LSCA, left subclavian artery; LV, left ventricle; RA, right atrium; RCA, right carotid artery; RV, right ventricle; SVC, superior vena cava.
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The final diagnosis was D-TGA with aberrant origin of the RSCA from the RPA (Figure 3).
PMC7341379_02
PMC7341379_03