All of the following are true regarding tetralogy of Fallot except:: (A) Ejection systolic murmur in second intercostal space, (B) Single second heart sound, (C) Predominantly left to right shunt, (D) Normal jugular venous pressure
Answer is C. c. Predominantly left to right shunt(Ref: Nelson's 20/e p 2211-2217, Ghai 8/e p 420-423)Right to left shunt is seen in ToF i.e. blood going from the pulmonary circulation to the systemic circulation Physical examination in a case of TOF shows: Cyanosis and clubbing, Normal jugular venous pulse (as there is no heart failure), a Single second heart sound (S2) and Ejection systolic murmur in pulmonary area.