Clinical features
Affected infants are cyanotic within a few days of birth and a continuous murmur due to bronchial collaterals and/or a patent ductus arteriosus can be heard all over the precordium.
Presentation is variable:
- congestive heart failure due to increased pulmonary blood flow via bronchial collaterals
- severe cyanosis requiring prostaglandin E1 to maintain the ductus arteriosus and palliative surgery
A few patients have sufficient pulmonary blood flow and can be managed as for less severe tetralogy
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