This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: C.V.S, Subject name: Medicine
All of the following are true regarding Tetralogy of Fallot except 
Select and explain. 
A. Ejection systolic murmur in second intercostal space, B. Single second hea sound, C. Predominantly left to right shunt, D. Normal jugular venous pressure
C: Predominantly left to right shunt
Answer: C: Predominantly left to right shunt 
Explanation: The four components of the tetralogy of Fallot are malaligned VSD, obstruction to RV outflow, aoic override of the VSD, and RV hyperophy due to the RV's response to aoic pressure the large VSD When the RV outflow obstruction is severe, pulmonary blood flow is reduced markedly, and a large volume of desaturated systemic venous blood shunts right-to-left across the VSD. ( Harrison&;s principle of internal medicine,18th edition,pg no. 1927)