A child with large VSD manifests in:

Ans: C (2 months) Ref: Pediatric Cardiology for Practitioners by Park. 4th edition, pg: 139 Nelson Textbook of Pediatrics, 19th editionExplanation:"CHF develops in infants with large VSDs, but usually not until 6 to 8 weeks of age." Pediatric Cardiology for Practitioners by Park pg 139 "Moderate to large VSDs produce a holosystolic murmur that is present by age 2 to 3 weeks." Ref: Merckmanuals"In children with a larger defect (VSD), symptoms of HP (eg, respiratory distress, poor weight gain, fatigue after feeding} appear at age 4 to 6 wk when pulmonary vascular resistance fails." Ref: Merckmanuals "CHF develops in large VSD, after 8 weeks of age." IAP Textbook of Pediatrics by Parthasarathy, 3rd edition; Pg: 397