1. S3: Answer Normal in young athletes 2. Decreased Pulmonary Blood Flow: Answer Cyanosis Squatting Loss of Consciousness Dizziness Syncope 3. Increased pulmonary blood flow: Answer Tachypnea with activity/feeding Diaphoresis Poor weight gain Exercise intolerance Dyspnea on exertion 4. CHD Evaluation: Answer Increased RR and /or effort at rest or with activity Poor feeding; fatigues during feeding Excessive sweating in infant, unrelated to the environment, especially while feeding Recurrent respiratory infections Decreased exercise tolerance Squatting with fatigue (rare) Chest pain (uncommon, usually non cardiac origin)- most common with severe aorticstenosis Syncope (uncommon) Child with cyanotic heart defect squats (knee-chest position) to relieve cyanosisspells