Newborn Has Trouble Eating, Heart Murmur – Let’s Diagnose

Parents brought their newborn to the pediatrician for a well-visit appointment 4 days after his birth. He was a full-term baby with no complications during delivery. The baby’s mother expressed some concern because she had been having a harder time breast feeding him than with her first two children. She also thought he seemed much sleepier or faster to fatigue than other newborns, in her experience. Just today, the baby’s father wondered if the baby had a slightly blue cast to his skin. Both parents were a little worried, but also thought maybe they were overreacting to being parents of a newborn once again. The doctor detected a heart murmur during the exam. She also noticed that when the baby exerted himself, he seemed to become short of breath. When taking the baby’s blood pressure, the doctor noted a wide pulse pressure.

Is it patent ductus arteriosus, ventricular septal defect, Ebstein anomaly, or atrial septal defect?

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