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Critical congenital heart defects In cyanotic CHDs: right-to-left…

- - - - Cyanosis
      - Respiratory distress
      - Failure to thrive
      - Cardiac examination findings
      - Bounding peripheral pulses
      - Harsh systolic murmur at the lower left sternal border
      - Loud S2
- - - - Central cyanosis (occurs within days after birth)
      - Tachypnea
      - Cardiac examination findings
      - Holosystolic murmur at the lower left sternal border
      - Single S2
      - Jugular venous distention with a prominent A wave
      - Diminished peripheral pulses
- - - - blood pressure is higher proximal to the narrowing, but is lower distal to the narrowing
      - ■ ➔ Weaker femoral pulse vs. brachial (= brachio-femoral delay)
      - the narrowing increases blood flow to the brain ➔ increases the pressure in the cerebral circulation ➔ ↑ risk of cerebral hemorrhage.