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: Unknown
Patient with VSD develops pulmonary hypertension. Which of the following will be present? 
Select and explain. 
A. Ejection systolic murmur in pulmonary area, B. Initial resolution of symptoms, C. Clubbing, D. Palpable A2
B: Initial resolution of symptoms
Answer: B: Initial resolution of symptoms 
Explanation: Ans is B. Point to understand is that pulmonary hypertension leads to Eisenmenger syndrome but they are not the same. Cyanosis and clubbing occur in Eisenmenger (reversal of shunt) but not in pulmonary hypertension per se. Cause of CCF is increased pulmonary blood flow. When pulmonary hypertension develops, blood flow to lungs decreases and initial improvement in symptoms is seen.