The truncus arteriosus or common arterial trunk, is a form of congenital cyanotic heart disease where only one artery arises from the heart, being responsible for the systemic, pulmonary and coronary circulation. It occurs in 1.5% of cases of congenital heart defects in newborns, presenting variations in their presentation as to the origin of the pulmonary trunk. We present a case of 6 month old male boy who presented with complains of fast breathing and respiratory distress. On examination, there was no cyanosis and clubbing. A systolic murmur was heard at mitral area. Chest radiography showed B/L non homogenous opacity with cardiomegaly. Hence a clinical diagnosis of Acyanotic heart disease most probably VSD with congestive cardiac failure with pneumonia was made. But ECHO Cardiography showed Truncus arteriosus Type 1. Here we want to emphasize that truncus arteriosus, though classified as a cyanotic heart disease may present without cyanosis in late infancy.
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