LAUSR

1. Aamir Jeewa, MD* 2. Shaine A. Morris, MD, MPH* 3. William J. Dreyer, MD* 4. Iki Adachi, MD† 5. Susan W. Denfield, MD* 6. E. Dean McKenzie, MD† 1. *Lillie Frank Abercrombie Section of Cardiology, Department of Pediatrics; 2. †Michael E. DeBakey Department of Surgery, Division of Congenital Heart Surgery, Baylor College of Medicine, Houston, TX. A 6-year-old girl of South Asian descent has a history of reactive airway disease that has been treated with bronchodilators from age 3 years. She is referred to a pulmonologist for refractory wheezing after multiple antibiotic courses and treatments with levalbuterol and corticosteroids, both oral and inhaled. Her parents had noted an increase in wheezing and upper respiratory tract infections during the winter months. She has no history of recurrent pneumonias or other hospitalizations. Prior chest radiographs had not shown any significant pulmonary pathology but incidentally did show evidence of scoliosis. The patient’s parents had noticed a chest deformity since the age of 4 years. Allergy testing shows she is allergic to mold, eggs, grass, and peanuts. The patient’s perinatal history is unremarkable. The family history is notable for a maternal grandfather who died suddenly after developing chest pain at 45 years of age. The patient’s initial physical examination reveals a Sexual Maturity Rating 1 girl with a thin build (84th percentile for height and 27th percentile for weight), …