Tetralogy of Fallot

Tetralogy of Fallot (ToF) is a cyanotic congenital heart disease caused by anterior displacement of the aorticopulmonary septum, causing unequal division of the truncus arteriosus. This causes four separate malformations, hence the name “tetralogy”:

• Pulmonary infundibular stenosis (narrow right ventricular outflow tract)
• Ventricular septal defect
• An overriding aorta
  • The aorta originates right over the VSD, so blood from the right ventricle enters the aorta during systole
• Right ventricular hypertrophy

Diagnosis and evaluation

Echocardiography confirms the diagnosis. Chest x-ray would show a boot-shaped heart.

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