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Physical examination confirms cyanosis.
The child may have clubbed fingers, an obvious thickening of the fingertips in response to the poor oxygenation.
Abnormal heart sounds, a heart murmur, and lung crackles may be heard.
Tests will vary depending on the suspected cause, but may be extensive and include a chest X-ray, a complete blood count (CBC), arterial blood gas analysis, ECG (echocardiogram), echo-Doppler, transesophageal echocardiogram (TEE), nuclear imaging tests, cardiac catheterization, and electrophysiologic study (EPS).
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