A neonate has recurrent attacks of abdominal pain, restless irritability and diaphoresis on feeding. Cardiac auscultation reveals a nonspecific murmur. He is believed to be at risk for M.I. Likely diagnosis here is:
Normally coronary aery arise from the aoic root, but in this condition it arise from the pulmonary aery. In this case oxygen supply to myocardium is compromised due to delivery of deoxygenated blood and low perfusion pressures. Soon after bih (Neonate) as the pulmonary aerial pressure falls, perfusion pressure to the left coronary aery becomes inadequate. Myocardial infarction and fibrosis may result. Ref: Kliegman, Behrman, Jenson, Stanton (2008), Chapter 432.2, "Anomalous Origin of the Coronary Aeries", In the book, "NELSON TEXTBOOK OF PEDIATRICS", Volume 2, 18th Edition, New Delhi, Pages 1930-31
ASD
VSD
TOF
Anomalous coronary aery