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A 2-year-old boy with known tetralogy of Fallot and a right modified Blalock-Taussig shunt is referred to you in the emergency room with severe cyanosis, having been ill for the past two days with a runny nose, cough and poor appetite. He is irritable but alert with deep sighing and rapid respiration. You can't hear a shunt murmur but a soft ejection murmur is present. What has happened and how will you manage him (see below)?
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