**Core Concept**
Congestive cardiac failure (CCF) in newborns can present with various symptoms and signs due to the immaturity of the cardiovascular system. One uncommon finding in CCF in newborns is related to the unique anatomy and physiology of the fetal circulation.

**Why the Correct Answer is Right**
In newborns, CCF often presents with signs of heart failure, such as tachypnea, tachycardia, and hepatomegaly. However, an uncommon finding in this population is the presence of a patent ductus arteriosus (PDA) as a result of failure of ductal closure after birth. The PDA allows blood to shunt from the aorta to the pulmonary artery, increasing pulmonary blood flow and further exacerbating heart failure.

**Why Each Wrong Option is Incorrect**
**Option A:** Hypertrophic cardiomyopathy is not typically seen in newborns with CCF, as it is more commonly associated with older children and adults.
**Option B:** Pulmonary hypertension is a complication of CCF, but it is not an uncommon finding in newborns.
**Option C:** Coarctation of the aorta is a congenital heart defect, but it is not typically associated with CCF in newborns.

**Clinical Pearl / High-Yield Fact**
Newborns with CCF often require careful management to prevent complications, including the use of prostaglandin E1 to maintain patency of the ductus arteriosus if necessary.

**Correct Answer:** D.