An Infant with Tachypnea and Failure to Thrive

A 2-month-old, full-term, immunized female infant with chronic congestion presented with difficulty feeding, poor weight gain, and hypoxia. One month prior to presentation, she began taking smaller volumes of formula, became fussier with feeds, and developed tachypnea unrelated to feeds. She was breastfed with formula supplementation but had suboptimal weight gain. On day of admission, she was found to have oxygen saturations in the 80s at her pediatrician's office. In the emergency department, she had central cyanosis, tachypnea, and increased work of breathing.

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