You are seeing a 2-year-old boy for the first time. His father denies any past medical or surgical history, but does note that the child's day care recently sent a note home asking about several episodes, usually after the child does not get what he wants, when he breathes funny and sits in a corner with his knees under his chin for a few minutes. The day-care staffers think this self-imposed time-out is a good thing, but they worry about the breathing. One teacher even thought he once looked blue, but decided that it was probably because of the finger paints he had been using. On examination, you identify a right ventricular impulse, a systolic thrill along the left sternal border, and a harsh systolic murmur (loudest at the left sternal border but radiating through the lung fields). His chest radiograph and ECG are shown. Which of the following congenital cardiac lesions would you expect to find in this child?
a) Ventricular septal defect (VSD)
b) Tetralogy of Fallot
c) Patent ductus arteriosus (PDA)
d) Atrial septal defect (ASD)