Explain the Clinical Features of PS and VSD ?

Symptoms :  A heart murmur is audible at birth. Cyanosis is present from early infancy, usually .from neonatal period. Normal birth weight and normal weight gain in easily infancy. H/o Hyper cyanotic spells present. H/o dyspnea on exertion present. H/o squatting present in older children.

Signs : Cyanosis, clubbing, polyeythemia and normal heart size on palpation. Mild parasternal impulse usually without systolic thrill. Single second sound.(widely split and inaudible pulmonary component). Loud Ejection systolic murmur (grade 3-5/6), heart best at middle and upper left parasternal border. Diastolic period is very clear, no S3, S4 or diastolic murmur.