The infant/child will have a harsh holosystolic murmur at the lower, left sternal border. They are at an increased risk of developing endocarditis at some point in their lifetime. Newborns are relatively asymptomatic but after PVR decreases, the left to right shunt occurs creating a murmur. Infants with a large ___________ will develop heart failure and have poor weight gain. Adults will develop pulmonary HTN, cyanosis and clubbing.