ECGs in the ED.

摘要

A 6-week-old infant girl presents to the Emergency Department with respiratory distress and poor oral intake. The respiratory symptoms started 5 days prior, and have worsened over time. The baby has been tachypneic and has had increased respiratory effort. There has been no fever or cough. Her oral intake has been less than usual since the tachypnea began. She normally takes 3 to 4 ounces every 4 hours, but this has recently decreased by about half. Her urine output is also decreased. She has been more lethargic than usual. There has been no vomiting or diarrhea. Her parents noted her to be pale today, and there was one episode of perioral cyanosis that prompted the family to bring her to the Emergency Department. The past medical history is significant for a term, uncomplicated pregnancy. The baby was born by spontaneously vaginal delivery. The Apgar scores were 8 at 1 minute and 9 at 5 minutes. She was discharged home on the second day of life. She had been thriving, with normal growth and development. Her only medication is a multivitamin She has no known drug allergies. The family history is noncontributory for congenital heart disease or sudden death. She lives with her parents and two siblings, both of who are healthy.