This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Other hea diseases in children, Subject name: Pediatrics
The following X - ray shows:- 
Select and explain. 
A. PPHN, B. Ebstein anomaly, C. TOF, D. TTNB
B: Ebstein anomaly
Answer: B: Ebstein anomaly 
Explanation: - The given X ray shows cardiac shadow occupying almost entire hemithorax, giving rise to a 'BOX SHAPED' hea which is a feature of Ebstein's anomaly - EBSTEIN ANOMALY: It is d/t downward displacement of posterior & septal leaflets of tricuspid valve resulting in atrialization of right ventricle Huge cardiomegaly is seen especially right atrium ECG - shows Himalayan P waves - PPHN: Aka Persistent pulmonary hypeension in newborn Failure of normal circulatory transition that occurs after bih resulting in hypoxemia. - TTNB: Aka Transient Tachypnea of New Born MCC of respiratory distress in a term neonate BASIC DEFECT - Delayed clearance of lung fluids RISK FACTOR - Delivery by cesarean section X-ray shows - Fluid in interlobar fissure , Pleural effusion , Perihilar streaking -TOF: MC congenital cyanotic hea disease in children 4 COMPONENTS: 1. Large, unrestricted VSD 2. Pulmonary infundibular stenosis 3. Overriding of aoa 4. Right ventricular hyperophy X-ray shows --> Boot shaped hea / coeur en sabot