Boot-shaped heart

Last revised by Jay Gajera on 1 Feb 2025

A 'boot-shaped' heart ("cœur en sabot" in French) is the description given to the appearance of the heart on plain film in some cases of Tetralogy of Fallot. It describes the appearance of an upturned cardiac apex due to right ventricular hypertrophy and a concave pulmonary arterial segment due to reduced pulmonary artery outflow from the subpulmonic stenosis. 

Cases and figures

  • Case 1
  • Case 2
  • Case 3
  • Case 4
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