<prompt> A child with VSD develops the following findings. There is no history of fever. What is the probable cause of these findings?Infective endocarditisEissenmenger syndromeCyanotic spellPatent ductus aeriosus  <response>: -- Clubbing cyanosis in a child with VSD, with no history of fever, is suggestive of Eisenmenger syndrome. -- EISENMENGER SYNDROME: Any untreated congenital cardiac defect with intracardiac communication that leads to pulmonary hypeension, reversal of flow , cyanosis. -- VSD FEVER CLUBBING -- suggestive of INFECTIVE ENDOCARDITIS -- CYANOTIC SPELL TET SPELL: Episodic central cyanosis due to total occlusion of right ventricle outflow in a patient with a congenital hea disease, such as Tetralogy of Fallot TOF. -- PATENT DUCTUS AERIOSUS: Persistence of connection bw pulmonary aery aoa even after bih. 