This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pediatrics
A patient of VSD in CCF develops clubbing with no cyanosis diagnosis is - 
Select and explain. 
A. Right to left shunt, B. Left to right shunt, C. Subacute bacterial Endocarditis, D. Pulm. edema
C: Subacute bacterial Endocarditis
Answer: C: Subacute bacterial Endocarditis 
Explanation: Ans. is 'c' i.e., i.e., Subacute bacterial endocarditis Clubbing in a patient with VSD suggest infective endocarditis. Course and complications of VSD 70 to 80 % of all VSD become smaller in size or disappear entirely --> Spontaneous closure of VSD. Common complications of VSD are : - 1) Pulmonary hypeension 2) CHF 3)Infective endocarditis VSD is the commonest CHD complicated by infective endocarditis. 4) Aoic regurgitation.