This directed case study is based on the true story of a 26-day-old infant who died from congenital heart defects (CHDs). The clinical tests performed on this baby are explored as the 20-year-old brother learns how a malformed heart and defective red blood cells affected the perfusion of the body’s tissue leading to eventual death. The case familiarizes students with heart anatomy and function, and blood composition. Students draw on their prior knowledge of blood flow through the heart to understand how the underlying conditions affected the infant and how the cardiovascular system is linked to the respiratory system. The case concludes with the examination of two medications and their pharmacology. Questions are included to explore several malformations of the heart (PDA, ASD, VSD, and DORV), and how they affect blood flow, perfusion of the body’s tissue, as well as composition and function of the blood. The case is particularly well suited for undergraduate or graduate human anatomy and physiology courses.