I. Heart failure: Neonatal heart failure is considered an acute condition, usually mostly due to a more severe heart defect in the child. Its clinical manifestations are due to congestion of the pulmonary and body circulations and a decrease in cardiac output. The child is pale, breath-holding, dyspnea and tachycardia, with a heart rate of up to 160-190 beats per minute, and blood pressure is often low. A galloping horse rhythm may be heard. The liver is large, but peripheral edema is less common. Cyanosis: The presence or absence of cyanosis depends on the nature of the heart malformation, such as atrial septal defect, ventricular septal defect and arteriovenous ductus arteriosus, which usually have no cyanosis in the early stage, but may appear after strenuous activity or crying and laughing. In children with right-to-left shunt congenital heart disease and severe cardiac malformations, such as tetralogy of Fallot, cyanosis may appear after birth or in the first few weeks to months, and it may gradually worsen. The cyanosis is most obvious in the tip of the nose, lips of the mouth and nail beds of the fingers (toes). Squatting: Children with cyanotic congenital heart disease, especially those with tetralogy of Fallot, often show signs of squatting after activity, which increases the vascular resistance of the body circulation and thus reduces the right-to-left shunt produced by the septal defect, and also increases venous blood flow back to the right heart, thus improving pulmonary blood flow. Fourth, pestle finger (toe) and erythrocytosis: cyanotic congenital heart disease is almost always accompanied by pestle finger (toe) and erythrocytosis. The mechanism of pestle finger (toe) is not clear, but erythrocytosis is a physiological response of the body to arterial hypoxia. V. Pulmonary hypertension: When patients with septal defects or unclosed ductus arteriosus present with a syndrome of severe pulmonary hypertension and cyanosis, it is called Eisenmenger’s syndrome. The clinical manifestations are cyanosis, erythrocytosis, pestle fingers (toes), signs of right heart failure, such as jugular vein anger, hepatomegaly, peripheral tissue edema, when the patient has lost the opportunity of surgery, the only waiting is heart and lung transplantation. Most patients die before the age of 40. Developmental disorders: Children with congenital heart disease often have abnormal development, manifesting as thinness, malnutrition and growth retardation. Other: chest pain, syncope, sudden death.