《儿科学》课程作业习题（典型病例）03 congenital heart disease-TOF

Medical number: 666419Diagnosis: Tetralogy of FallotHistory summaryMale, I year and 6 months old.2.Chief complaints cyanosis with cryinggfor4months4monthsago,penurduringroutinephysicalexamirpatient caught a cold.He had been cyanosis with crying, squatting and easy fatigability sincethenHehasnosignsoftachypnea, syncope,edemaPast history:The mother caught a cold during early stage of pregnancy without medicationtherapyns:AllImrizatiFeeding Good6.Family History:The mother and thefather are healthy.Thefamily has no history of congenitalheartdiseaPhysical Examination on Admission:T:36.8℃, P:110bpm,R25bpm,weight:9kg,BP93/47mmHg, Sp02 90%.He seemescious and quiet. Perioral cyanosis. No rashes.edemaand dry rales in both lungs. Heart: RV lif. A grade II/VI, rough,ejection-type systolic murmur was heard at the lef sternal border in the third intercostal spaceThe second sound at the pulmonary area decreased. Abdomen: Sof, no pain, mass, thrillorfluid wave.Liver is palpable1.5cm belowthe rightcostal margin.No clubbing offingers andto9.Ingationtests(1) Echocardiogram: Tetralogy ofFallot.(2) ECG: normal.(3)Chest radiograph:Boot shaped heartTreatment:Surgery

Medical number: 666419 Diagnosis：Tetralogy of Fallot History summary: 1. Male, 1 year and 6 months old. 2. Chief complaints: cyanosis with crying for 4 months. 3. 4 months ago, pediatrician found heart murmur during routine physical examination when the patient caught a cold. He had been cyanosis with crying, squatting and easy fatigability since then. He has no signs of tachypnea, syncope, edema. 4. Past history: The mother caught a cold during early stage of pregnancy without medication therapy. 5. Immunizations: All. 6. Feeding: Good. 7. Family History: The mother and the father are healthy. The family has no history of congenital heart disease. 8. Physical Examination on Admission: T: 36.8℃，P:110bpm，R: 25bpm，weight：9kg, BP: 93/47mmHg, SpO2 90%. He seemed conscious and quiet. Perioral cyanosis. No rashes or edema. No moist and dry rales in both lungs. Heart: RV lift. A grade III/VI, rough, ejection-type systolic murmur was heard at the left sternal border in the third intercostal space. The second sound at the pulmonary area decreased. Abdomen: Soft, no pain, mass, thrill or fluid wave. Liver is palpable 1.5cm below the right costal margin. No clubbing of fingers and toes. 9. Investigation tests: (1) Echocardiogram: Tetralogy of Fallot. (2) ECG: normal. (3) Chest radiograph: Boot shaped heart. Treatment: Surgery