which heart condition does the child have ? Also, take a look at this http://forum.facmedicine.com/spot-diagnosis/13382-spot-diagnosis.html#post37654 I would appreciate, if u guys post ur reasons in favor of ur diagnosis. Differentials are also welcome. (-:
Hint : Everything that wheezes is not asthma, similarly everything heart that looks like a boot in pediatric CXR is not TOF. It's to drive home this point, that i put this case up....but becos i said differentials r welcome, i will accept TOF as a differential, but this is not TOF.
This is an excellent image Neo_star, thank you! I have spent some time looking at this image, as I too thought of ToF on first glance. However on further inspection I am convinced this is aortic coarctation. If you look closely at the "aortic knuckle" you can see the classical indent - the so called "figure of 3 sign" (which I failed to spot on first glance - it's quite subtle). Then, look at the ribs on both sides: you can see the classic notching of the ribs caused by dilated intercostal collateral vessels (Roesler sign).
Ans: Coarctation of aorta as demonstrated by the subtle "figure of 3 sign" and the rib notching. Credit to Dr. kangourou for clinching the diagnosis.
