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Clinical features of RIGHT to LEFT shunts (cyanotic congenital heart disease)

Clinical features of cyanotic heart disease depends on whether the lesion is associated with increased or decreased pulmonary blood flow.
Features of Cyanotic heart disease with increased pulmonary  blood flow
  •   Patient is mildly cyanotic
  •    Increased sweating is seen
  •   Congestive cardiac failure is common
  •   Failure to thrive occurs
  •   Plethoric lung fields and cardiomegaly is seen in chest x-ray
  •   Examples are TGA, single ventricle, TA, Total anomalous pulmonary  return w/o obstruction
Cyanotic heart disease with decreased pulmonary  blood flow
  •   Moderate to severe cyanosis is seen.
  •   ESM, delayed and diminished  P2 (PS) is heard
  •   In  Pulmonary hypertension ,accentuated & palpable P2,ESM is heard.
  •   Oligemic lung fields on chest xray
  •   Examples are TOF, PA, TA, total anomalous pulmonary. return w/ obstruction