Pediatric Congenital Heart Disease & Respiratory Illness Case Study: 18-Month-Old with Cough & Decompensation | Primary Care 2025/2026

A high-acuity pediatric case study for 2025/2026 on an 18-month-old female with complex congenital heart disease (single ventricle physiology, status post bidirectional Glenn) presenting with acute cough, increased work of breathing, and signs of heart failure exacerbation. This case explores the critical intersection of viral bronchiolitis and cardiac decompensation in medically fragile children. Includes comprehensive history taking, physical examination findings (hepatomegaly, wheezing, poor perfusion), urgent diagnostic testing (CXR, echocardiogram, BNP, viral panel), and intensive management in a cardiac ICU setting. Emphasizes red flag recognition, multidisciplinary care coordination, and family communication. Essential for pediatric primary care providers, advanced practice nurses, and clinicians managing children with medical complexity.