A 3monthold infant who was previously healthy now has a persistent cough,
bilateral lung crackles, and poor appetite. The primary care pediatric nurse practitioner auscultates a grade III/VI, lowpitched, holosystolic murmur over the left lower sternal border and palpates the liver at one centimeter below the ribs. What diagnosis is likely?

Question

A 3­month­old infant who was previously healthy now has a persistent cough,
bilateral lung crackles, and poor appetite. The primary care pediatric nurse practitioner auscultates a grade III/VI, low­pitched, holosystolic murmur over the left lower sternal border and palpates the liver at one centimeter below the ribs. What diagnosis is likely?

Quizplus · Accepted Answer

The symptoms described, including the holosystolic murmur at the left lower sternal border, suggest a ventricular septal defect (VSD), which is a common congenital heart defect in infants. The liver enlargement and respiratory symptoms are consistent with heart failure due to the left-to-right shunt caused by the VSD.

A 3­month­old Infant Who Was Previously Healthy Now Has a Persistent

A 3monthold Infant Who Was Previously Healthy Now Has a Persistent