A 3-month-old 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, low-pitched, holosystolic murmur over the left lower sternal border and palpates the liver at one centimeter below the ribs. What diagnosis is likely?

Question

Quizplus · Accepted Answer

The symptoms described, including a persistent cough, poor appetite, and a grade III/VI, low-pitched, holosystolic murmur over the left lower sternal border, along with liver enlargement, are indicative of a ventricular septal defect (VSD). These symptoms suggest increased pulmonary blood flow and heart failure, which are common in significant VSDs.

A 3-Month-Old Infant Who Was Previously Healthy Now Has a Persistent