Subcostal Retractions While Feeding in Pediatrics — Case | Pediatric Cardiology | SMLE Q#11264
SMLE Question #11264
Pediatrics
Pediatric Cardiology
Objective: OBJ-283
Last updated: February 2026
An 8-week-old girl has 2 weeks of wheeze, cough, poor feeding, and poor weight gain. She sweats and tires during feeds and takes longer to finish bottles. Her weight has fallen from the 50th to below the 10th percentile. She is tachypnoeic with subcostal retractions while feeding. Examination shows a hyperdynamic precordium, a loud high-pitched holosystolic murmur at the lower left sternal border, bilateral basal crackles, and hepatomegaly (liver 3 cm below the right costal margin) without cyanosis. What is the most likely underlying diagnosis?
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