IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Tetralogy of Fallot

Case contributed by Mohammad A. ElBeialy
Diagnosis almost certain

Presentation

Cyanotic baby.

Patient Data

Age: 1 year.
Gender: Male
x-ray

Conventional radiograph shows typical boot-shaped heart with upturned cardiac apex indicative of right ventricular hypertrophy as well as concave pulmonary arterial segment indicative of pulmonary hypoplasia.

ct
  • large subaortic ventricular septal defect (VSD) with an over-riding aorta. The over-riding aorta is dilated and measures 1.6 cm in its maximal diameter at the level of the main pulmonary artery (MPA)
  • antegrade continuity between the right ventricle (RV) and MPA with severe infandibular and valvular pulmonary stenosis
  • confluent relatively small sized MPA with fair caliber of its major branches
  • left-sided aortic arch with common bovin origin of the left CCA and the brachiocephalic artery
  • mild cardiomegaly with right ventricular hypertrophy
  • situs solitus, apex to the left
  • atrio-ventricular and ventriculoarterial concordance
  • no evident anomalous pulmonary venous drainage
  • no PDA
  • No major aorto-pulmonary collaterals (MAPCAs).

Case Discussion

A typical case of tetralogy of Fallot (TOF) with subaortic VSD, over-riding aorta, pulmonary stenosis and right ventricular hypertrophy.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.