Congenital Heart Disease USMLE Step 1 Practice Question
A 2-day-old male infant born at 38 weeks gestation presents with cyanosis and tachypnea (RR 60/min). On physical examination, blood pressure is significantly lower in the right upper extremity compared to the left, and the right radial pulse is diminished. Pulse oximetry shows SpO2 of 88% on room air that does not improve substantially with supplemental oxygen. Chest X-ray reveals cardiomegaly and mild pulmonary edema. Echocardiography demonstrates a large patent foramen ovale with right-to-left shunting and an unusual aortic arch configuration. Which of the following is the most likely diagnosis?
Answer choices
- ACoarctation of the aorta with patent ductus arteriosus
- BAnomalous origin of the right subclavian artery from the descending thoracic aortaCorrect answer
- CInterruption of the aortic arch type B
- DTransposition of the great arteries with an aberrant right subclavian artery
- ETetralogy of Fallot with a vascular ring
- FHypoplastic left heart syndrome
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