Tetralogy of Fallot

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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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