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Nirav Shastri, MD

Arch Pediatr Adolesc Med. 2007;161(7):711.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

A term baby was born by spontaneous vaginal delivery to a gravida 5, para 5 mother. His Apgar score was 7 after 1 minute. At 5 minutes, the score was 8 because of the presence of acrocyanosis and low heart rate. He was appropriate for gestational age with a birth weight of 3417 g, length of 51.7 cm, and head circumference of 35.5 cm. On examination, there was a bifid thumb with duplication of the distal phalanx on the right hand (Figure 1). On auscultation, an ejection systolic murmur grade 2/6 on the left sternal border was heard. Electrocardiography showed bradycardia with a heart rate of 93 beats/min. Echocardiography revealed a secundum atrial septal defect measuring 1.33 cm (Figure 2). There was no family history of any limb or heart defects.

Figure appears in full text version. Figure 1. Bifid thumb on right hand.

Figure appears in full text version. Figure 2. Echocardiogram (subcostal view) . . . [Full Text of this Article]

Author Affiliation: Department of Pediatrics, University of Kansas Medical Center, Kansas City.

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