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Which of the following clinical pathophysiologic manifestations are consistent with a large ventricular septal defect (VSD) ?
I.The majority of the blood flow is shunted from left right to right left.
II.Shunting typically occurs during ventricular diastole,which causes left atrial enlargement.
III.Chest radiography reveals an enlarged cardiac silhouette and increased pulmonary vascular markings,increasing pulmonary blood flow.
IV.Thickening and fibrosing of the pulmonary veins develop,decreasing pulmonary artery pressure.
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