This is a three day old neonate (male)of a twin pregnancy(1.9kg)presented with tachypneic since birth.
On auscultation no significant murmur but with laud 2nd heart sound.
Saturation in (pre ductal )is 98% with 0.5L /min, and post ductal was 88%.
He had moderate pulmonary hypertension( TR = 50mmhg) with dilated RA/RV.
There was a Large AP window(8mm ) with balance shunt.
