The infant is thin, malnourished and fussy. She is not cyanotic but is tachypneic. Pulses are equal in all extremities.
The baby appeared healthy after birth. Birth weight was 3.2 kg (50%), length was 50 cm (50%).
The infant was discharged home in two days. She was bottle
fed with a cow's milk formula, feeding 3 to 5 oz. every 3 hours. She initially
did well. At about three weeks of age her mother noticed that the infant
appeared to have some trouble finishing a bottle. By the time the infant
was brought to your office it would take about an hour to finish 1/2 to
2/3 of a bottle.
The baby did have a 2 week check-up and was thought to
be well although a heart murmur was heard.
She has not been back to the doctor’s office until today.
Physical Exam:
Age = 2 months
Weight = 4.0 kg (25%)
Height = 55 cm (25%)
Heart Rate = 165 beats per minute
Respiratory Rate = 60 breaths per minute
Blood Pressure = 85/60 mm Hg
The infant is thin, malnourished and fussy. She is not
cyanotic but is tachypneic. Pulses are equal in all extremities.
Cardiovascular Exam:
A heave is felt below the xyphoid process.
Heart Sounds
Laboratory Evaluation:
