Tetralogy of Fallot

Case contributed by Dr. Ahmed Mohamed Abaker Babai

Presentation

Recurrent respiratory tract infection, cyanosis and reduced overall activity.

Patient Data

Age: 3 years
Gender: Female

Chest

X-ray

Enlarged cardiac shadow, with supra-diaphragmatic apex denoting left ventricular hypertrophy.

Double density sign of left atrial hypertrophy and straightening of the left cardiac border, denoting left to right shunt. 

Prominent pulmonary vasculature centrally, with peripheral oligemia.

Overall boot shaped heart.

Case Discussion

AP chest x-ray showed boot shaped heart. With signs highly suggestive of tetralogy of Fallot.

Echocardiogram was requested for confirmation. We relied on the clinical picture and radiographic signs. Propper diagnosis usually based on CT or MR cardiogram.

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