n CME : Your SA Journal of CPD - Neonatal cardiac emergencies




A day 2 term neonate, delivered uneventfully following prolonged rupture of membranes, is referred to you with respiratory distress since the previous night in the postnatal ward. He has obvious central cyanosis and on auscultation you hear no murmurs. His arterial blood gas shows severe hypoxaemia with a metabolic acidosis. You initially suspect congenital pneumonia but then notice that his chest radiograph shows clear 'black' lung fields and a boot-shaped heart. What is a more likely diagnosis? Why was he apparently well for the first day?


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