Recurrent respiratory tract infections may occur in all of the following except –
Chest infections are frequent in the following two groups of congenital cardiac anomalies.
a) Left to right shunts → This group includes

Atrial septal defect
Ventricular septal defect
Patent ductus arteriosus
This group of CHD's are characterized by frequent chest infections.
There is large flow of blood in the lungs which causes lung infections.
Each attack of cold seems to turn into Bronchopneumonia.
It is not uncommon for these patients to have 6-8 attacks of pneumonia in the first year of life.

b) Cyanosis with increased pulmonary blood flow.

A large no. of conditions result in a combination of cyanosis with increased pulmonary blood flow.
Common to these conditions is the presence of abnormal mixing of pulmonary venous blood with the systemic venous blood and absence of obstruction to pulmonary blood flow.
The anomalies included in this group are


Transposition of great vessels
Total anomalous pulmonary venous connection
Single ventricle without obstruction to pulmonary blood flow.
Persistent truncus arteriosus
Tricuspid atresia with absence of obstruction to pulmonary blood flow.
Double outlet right ventricle without pulmonary stenosis.


Clinically these patients are characterized by


Cyanosis
Cardiomegaly
Almost 80% of these patients are lost due to congestive cardiac failure or pulmonary infection.

Congenital heart diseases which are not predisposed to pulmonary infection
1) Right to left shunts                                                 

This group includes                                                       
Tetralogy of Fallot                                                     
Ebstein's anamoly            

 2) Obstructive lesions         

This group includes         
Aortic stenosis             
Coarctation of Aorta           
Pulmonary stenosis

Characteristic of this group is                                         

Presence of cyanosis           
The absence of chest infections          

Clinical characteristic of this group

The absence of frequent chest infections and cyanosis
The absence of a precordial bulge
Presence of forcible or heaving cardiac impulse.
Ventricular septal defect
Tetrology of Fallot
Transposition of great arteries
Total anomalous venous return