5)      In atrial septal defectsa)       Ejection systolic murmur is due to blood flow through the atrial septal defectb)      Commonest  is ostium secundum typec)       ECG shows RBBBd)      Ostium primum defects are located higher up in the atrial septume)      P2 is soft Best Response MCQ 6)      A four year old child with ventricular septal defect is evaluated in the clinic. She has defaulted follow up since one year of age.             The most relevant  indicator for a  poor outcome is