Describe about Transposition of great arteries with large ventricular septal defect ?

Transposition of great arteries with large ventricular septal defect: Usually the intercirculatory shunt is large resulting in good mixing. As a result the neonate may not initially manifest any signs or symptoms of heart disease. Mild cyanosis may be noted during crying1straining.A~t he pulmonary vascular resistance falls, the shunting from light ventricle to left ventricle increases, directing more blood flow into the 1ungs.This in turn results in greater venous retune into the left atrium and a proportionate increase in the left to right shunt across the inter-atrial communication (PFO or ASD).Reshictive inter-atrial communication results in the child becoming symptomatic by ten to fifteen days of life with congestive cardiac failure and pulmonary venous congestion. Classically, TGA /large VSD presents with CHF between 2-6 weeks of 1ife.Tachypnea and tachycardia become prominent, narrow-split S2 with loud P2 may appear, prominent grade 316-416 pansystolic murmur; S3 and mid-diastolic rumble and gallop rhythm may become appreciable.