A Presentation of Persistent Pulmonary Hypertension of a Newborn Mimicking Coarctation of Aorta

Abstract

A male newborn was born to a 18y/o mother at gestational age of 38weeks, birth weight 3295gm via emergent Cesarean section with the indication of fetal distress. The mother was diagnosed with type II DM and pregnancy-induced hypertension. Aspirin was given by a family doctor for prevention of preeclampsia during gestational age of 29 to 36 weeks. After birth, the baby presented persistent desaturation (SpO2 77-85%) and severe respiratory acidosis despite of resuscitation. CXR revealed cardiomegaly. Echocardiography showed remarkable dilatation of right ventricle and a huge Patent Ductus of Arteriosus (PDA) with almost right-toleft shunt. Persistent Pulmonary Hypertension of Newborn (PPHN) was diagnosed. However, the isthmus of aorta was restricted (the narrowest diameter was 0.220cm) (Figure 1).