Excerpt

An 8 year-old male with a history of bronchopulmonary dysplasia presented with cyanosis of the lips and nail beds, hypoxemia (peripheral O₂ saturation of 88%), and symptoms of an upper respiratory tract infection. His only chronic complaint was dyspnea and fatigue with extreme exercise. He had normal heart sounds without murmurs, and his chest radiograph and initial echocardiogram were both normal. A second echocardiogram (Fig. 1) was performed, which revealed abnormal septation of the right atrium. Cardiac catheterization confirmed anomalous inferior vena cava drainage into the left atrium (Fig. 2) with normal intracardiac pressures and normal pulmonary venous drainage.

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