Case 1
18-month-old is brought in by her mother as she is concerned about faltering growth. On further questioning, the child’s mother reveals that the infant often becomes sweaty and fussy when feeding and it seems as though they are struggling to breath. She has tried smaller, more frequent feeds, however, is now worried as the child is not gaining appropriate weight. You examine the child and note them to have cool peripheries and hepatomegaly. On auscultation, you note a pansystolic murmur at the lower left sternal edge.