CLINICAL HISTORY.—This 2-month-old boy was admitted to Childrens Hospital of Los Angeles because of apneic episodes and cyanosis. He was born prematurely and weighed 3 lb 1 oz (1,389 gm). He did well; there were no unusual problems until the present illness. Upon discharge from the premature center, the weight was 5 lb 1 oz (2,296 gm).
Four days prior to admission, the patient began to take his feedings poorly. On the day of admission he refused feedings entirely, had several apneic episodes, and appeared cyanotic.
Slight cyanosis and rapid respirations were noted by physical examination. There was a grade 1/6 short systolic murmur along the left sternal border and the liver was palpated 2-3 cm below the costal margin. Lethargy was present, but the remainder of the physical examination disclosed nothing abnormal.
The laboratory studies were all normal. The ECG was interpreted to demonstrate right axis deviation and right