Tetralogy of Fallot

  • Etiology: congenital
  • CXR: boot shaped heart – upward pointing cardiac apex due to right ventricular hypertrophy
  • Imaging: right ventricular outflow obstruction, right ventricle hypertrophy, over-riding aorta, ventricular septal defect, right arch in 20%
  • Note: in Tetralogy of Fallot with pulmonary atresia – no luminal continuity, no flow between right ventricle + pulmonary artery, blood leaves right ventricle via ventricular septal defect
  • Clinical: most common cyanotic congenital heart disease, right sided obstructed lesion with neonatal ductal dependence

Cases of Tetralogy of Fallot

CXR of tetralogy of Fallot
CXR AP shows decreased pulmonary blood flow, a right-sided aortic arch and an upturned cardiac apex resulting in a boot-shaped heart.
CXR of tetralogy of Fallot / TOF
CXR AP shows decreased pulmonary vascularity and a normal sized heart with the cardiac apex slightly upturned.