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It is the development of pulmonary hypertension due to reversal of blood flow from right side of heart to left

The common causes are

  1. Ventricular septal defect
  2. Patent ductus arteriosus
  3. Atrial septal defect

Signs and symptoms

  1. Cyanosis
  2. Clubbing
  3. Polycythemia
  4. Signs of right ventricular hypertrophy
  5. Loud P2
  6. Ejection click and ejection systolic murmur due to pulmonary hypertension

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