Transient right ventricular hypertrophy in an extremely low birth weight infant resembling duct-dependent pulmonary circulation: a case report

We report an extremely low birth weight infant (494 g, 23 weeks + 1 day) with transient right ventricular hypertrophy, initially suspected as pulmonary atresia with ductus-dependent circulation. Patent ductus arteriosus management was complicated, requiring low-dose PGE1 and eventual surgical ligation. Serial echocardiography revealed progressive right ventricular dilation and normalisation of function, confirming transient hypertrophy. This case highlights diagnostic challenges and the importance of repeated cardiac assessment in extremely preterm infants.