5.6.2 Clinical signs
Owing to the presence of a right to left shunt, one of the cardinal signs of tetof Fallot is central cyanosis. This may or may not be apparent on clinical examination, depending on the degree of shunting. Other signs include profound exercise intolerance, poor growth and CHF. Auscultation reveals loud (grade 4-6/6) murmurs on both sides of the chest, predominantly at the left base. A thrill is often present.