Case 3/2006: nineteen-month-old infant with pulmonary atresia and ventricular septal defect and decreased pulmonary blood flow.

Nineteen-month-old white male infant presenting with progressive cyanosis since birth. Dyspnea on minimum exertion was observed. Physical examination revealed respiratory distress, severe cyanosis, normal pulses, 45% oxygen saturation, weight of 8900 g, heart rate of 145 bpm, and blood pressure of 90/65 mmHg. The aorta was not palpable. No deformities were observed in the precordium, and the apical impulse was not palpable. Heart sounds were accentuated and a grade 1-2/6 blowing continuous murmur in the aortic area and in the right side of the posterior chest was observed. The liver was not palpable.