P AVSD X NO MURMUR IN EARLY INFANCY X CWH C1122574

The newborn with AVSD may present with a mild degree of central cyanosis. This finding relates to bidirectional shunting at both the atrial and ventricular level in the presence of elevated pulmonary vascular resistance at birth. The only positive precordial findings of a congenital heart defect at this time may be a right ventricular impulse and accentuated pulmonary component of the second heart sound. A precordial murmur may, at this stage, be much abbreviated or absent.1


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1861295/