An infant previously diagnosed with a large muscular VSD comes to the office with complaints from the mother of fatigue and poor feeding over the past month. You note the child has not gained weight since the previous visit 2 months ago. The child is apathetic, tachypneic, and has wheezes and crackles on lung auscultation.For the above mention case, choose the most likely cardiac diagnosis based on the patient's presentation.

Congestive heart failure can result from a number of causes, including congenital heart disease, Kawasaki disease, metabolic cardiomyopathies, arrhythmias, and viral myocarditis. The case presented is typical of an infant with heart failure. Such infants are weak, diaphoretic, have poor weight gain, and may be tachypneic with retractions. Lung findings can include crackles, wheezes, or both. Prompt evaluation by a pediatric cardiologist is imperative.