Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with symptoms suggestive of myocardial ischemia, including diaphoresis during feeding, irritability, and failure to thrive. History significant for recurrent episodes of respiratory distress and tachycardia. No prior history of congenital heart disease.
Clinical Examination Findings
Cardiovascular exam reveals a hyperdynamic precordium with a continuous machinery-like murmur at the left upper sternal border, radiating to the back. Signs of congestive heart failure noted, including hepatomegaly and tachypnea. Peripheral pulses are symmetric.
Treatment Protocol
Immediate surgical intervention via coronary artery reimplantation (direct aortic implantation) is indicated to establish a dual-coronary system. Post-operative management includes inotropic support, afterload reduction, and close monitoring for myocardial recovery and potential mitral regurgitation.