Progressive cyanosis develops during the first few days of life as the ductus arteriosus and foramen ovale begin to close.
At this critical stage the features are:
There may be a loud second heart sound because the transposed aorta is positioned anteriorly, next to the chest wall.
If there are additional lesions, the most common of which being a VSD, then cyanosis will appear later. This is because the additional lesion allows mixing between the two vascular circuits. These babies may develop signs of cardiac failure.
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