A 10 month-old male infant is brought to your clinic for a sick visit. The patient’s mother states she was having a bad morning which started when she found her baby having a seizure in his bed. On physical examination, you immediately noticed that the boy has a small mandible, cleft palate, low-set posteriorly rotated ears with notched pinnae and an abnormal increase in the distance between the orbits. When you tapped on the facial nerve, you noticed contraction of facial muscles. A complete cardiopulmonary evaluation revealed a loud, harsh holosystolic murmur in the left third and fourth interspaces along the sternum. CXR showed absent thymic shadow. Suspecting a genetic disorder, you consulted a genetics specialist, who detected a chromosome 22q11.2 deletion in fluorescence studies. What is the most likely diagnosis?
