Summary
Definition
History and exam
Key diagnostic factors
- systolic murmur left parasternal region
- failure to thrive
- shortness of breath
Other diagnostic factors
- recurrent pulmonary infections
- loud pulmonary component of the second heart sound
- cyanosis
- finger clubbing
- recent myocardial infarction (usually within 2 to 5 days)
- recent trauma
Risk factors
- family history of congenital heart disease
- Down syndrome (trisomy 21)
- maternal alcohol consumption during pregnancy
Diagnostic investigations
Treatment algorithm
Contributors
Authors

Professor of Clinical Medicine
University of Missouri
Columbia
MO
Disclosures
KA declares that he has no competing interests.
Dr Kul Aggarwal would like to gratefully acknowledge Professor Zuhdi Lababidi, a previous contributor to this topic.
Disclosures
ZL declares that he has no competing interests.
Peer reviewers
Acting Head
Department of Cardiology
Royal Children's Hospital
Melbourne
Australia
Disclosures
MC declares that he has no competing interests.
Consultant Paediatric Cardiologist and Honorary Senior Lecturer
Great Ormond Street Hospital and Institute of Child Health
London
UK
Disclosures
SK declares that he has no competing interests.
Attending Pediatric Cardiothoracic Surgeon
Medical University of South Carolina Children's Hospital
Charleston
SC
Disclosures
TYH declares that he has no competing interests.
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