This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: All India exam, Subject name: Pediatrics
A patient of moderate VSD in chronic CCF develops clubbing with no cyanosis. Diagnosis is 
Select and explain. 
A. Shunt reversal, B. Long standing pulmonary edema, C. SABE, D. Pulmonary aery hypeension
C: SABE
Answer: C: SABE 
Explanation: SHUNT REVERSAL / EISENMENGER SYNDROME: Refers to patients with the septal defect in which blood is shunted paially or completely from right to left as a result of the development of pulmonary vascular disease resulting in apparent cyanosis.Long-standing pulmonary edema is characterized by cyanosis, dyspnea.New onset clubbing without cyanosis in a patient with congenital hea defects indicates the development of SABE .Pulmonary aerial hypeension commonly occurs in large non-restrictive VSD and is unlikely in moderate VSD.