Right pulmonary artery to left atrium communication. An unusual cause of cyanosis in the newborn.

A one-day-old newborn infant presented with intense cyanosis, a continuous murmur, and mild congestive heart failure. The chest roentgenogram showed an abnormal right-heart border, and the echocardiogram demonstrated enlargement of the left ventricle and left atrium. Cardiac catheterization and angiography demonstrated a right pulmonary artery to left atrium communication. The infant responded favorably to medical management and is asymptomatic with the exception of mild cyanosis with crying. Right pulmonary artery to left atrium communication is a rare but potentially correctable cause of cyanosis in the newborn.