Review Question - QID 109352

A newborn boy is evaluated in the hospital nursery 30 minutes after birth. He was born at 37 weeks of gestation to a 38-year-old gravida 2 mother via vaginal delivery. The pregnancy was complicated by preeclampsia and the patient’s mother received routine prenatal care. The patient’s mother declined all prenatal testing including an anatomy ultrasound. Upon delivery, the patient had a weak cry with hypertonia and flexion of the extremities. The patient was placed on positive pressure ventilation with an improvement in his respiratory status. His Apgar scores were 6 and 7 at 1 and 5 minutes, respectively. His weight is 2430 g (5 lb 6 oz) and his height and head circumference are in the 24th and 2nd percentiles, respectively. His temperature is 97.8°F (36.6°C), blood pressure is 58/37 mmHg, pulse is 166/min, and respirations are 38/min. On physical exam, the patient has a prominent occiput. The patient has a holosystolic, harsh-sounding murmur at the left lower sternal border. He also has the physical exam finding seen in Figure A. This patient is most likely to have which of the following conditions?