All of the following are true regarding tetralogy of Fallot except:

c. Predominantly left to right shunt(Ref: Nelson's 20/e p 2211-2217, Ghai 8/e p 420-423)Right to left shunt is seen in ToF i.e. blood going from the pulmonary circulation to the systemic circulation Physical examination in a case of TOF shows: Cyanosis and clubbing, Normal jugular venous pulse (as there is no heart failure), a Single second heart sound (S2) and Ejection systolic murmur in pulmonary area.