A 6-Day-Old Boy in the Neonatal Intensive Care Unit Has

A 6-day-old boy in the neonatal intensive care unit has a heart murmur.  The patient was born at 27 weeks gestation and intubated due to surfactant deficiency.  Birth weight was 1.14 kg (2 lb 8 oz) .  Temperature is 37 C (98.6 F) , blood pressure is 66/12 mm Hg, and pulse is 182/min.  A continuous murmur with systolic accentuation is best heard at the left heart border.  There are bounding femoral and palmar pulses.  Abdominal examination is unremarkable.  Blood culture is sterile.  Elevated levels of which of the following substances is most likely contributing to this patient's condition?

A) Endothelin-1
B) Leukotriene D4
C) Prostaglandin E2
D) Thromboxane A2
E) Vasopressin

Correct Answer:

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