It is a condition whereby the patient will have well perfused pink upper extremities evident by the pink finger nails while the lower extremities will both have cyanosis and clubbing in the toes, as shown in the picture above. In adults, it is commonly seen in patients of Patent Ductus Arteriosus (PDA) who have Pulmonary Hypertension at the same time.
This occurs because venous blood shunts through the ductus and enters the aorta distal to the subclavian arteries.
In newborns, it can also occur in pre-ductal coarctation of aorta along with PDA.
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