Snapshot A neonate is born to a 23-year-old mother via a normal and uncomplicated spontaneous vaginal delivery. On examination, the neonatologist finds a holosystolic murmur at the lower left sternal border. Two days later, the murmur persists. The baby is sent for an echocardiogram to further evaluate the murmur. Introduction Clinical definition login to view 1 more bullet Etiology Pathogenesis login to view 2 more bullets Associated conditions login to view 3 more bullets Epidemiology Demographics login to view 2 more bullets Risk factors login to view 1 more bullet Presentation Symptoms login to view 7 more bullets Physical exam login to view 5 more bullets Imaging Radiography login to view 7 more bullets Echocardiography login to view 5 more bullets Differential Atrial septal defect login to view 2 more bullets Patent ductus arteriosus login to view 2 more bullets Diagnosis Making the diagnosis login to view 1 more bullet Treatment Management approach login to view 3 more bullets Medical login to view 10 more bullets Operative login to view 5 more bullets Complications Increased risk for subacute infective endocarditis Heart failure Eisenmenger syndrome Prognosis Most remain asymptomatic or self-resolve Larger defects can lead to left heart overload and heart failure