A 2-month-old with ventricular septal defect (VSD) and CHF should be managed with:

VSD causesleft-to-right shunting, leading tovolume overload, CHF, and poor weight gain. Management includes:

Digoxinto improve contractility

Diureticsto reduce preload

High-calorie feedsto support growth in the setting of increased metabolic demand

O₂ isnot routinely usedunless there's hypoxia, as it can increase pulmonary vascular dilation andworsen the shunt.

“Medical management of CHF in infants with VSD includes diuretics, digoxin, and nutritional support with caloric supplementation.”

(Referenced from CCRN Pediatric – Direct Care: Cardiovascular, Congenital Heart Defects and Heart Failure)