Rapid Review: Tetralogy of Fallot

August 3, 2017
Tetralogy of Fallot

Tetralogy of Fallot

  • Patient with a history of episodes of cyanosis (tet spells) and squatting for relief
  • PE will show pulmonic stenosis, right ventricular hypertrophy, overriding aorta, VSD
  • CXR will show “boot-shaped” heart
  • Comments: Most common cyanotic congenital heart disease
  • Mnemonic: PROVePulmonic stenosis, Right ventricular hypertrophy, Overriding aorta, VSD

Sample question:

A 1-year-old girl presents to the emergency room after her mother noticed that she became blue while crying. The patient subsequently squatted on the ground and the mother noticed a resolution in the cyanosis. On physical exam, the patient is now calm and vital signs are normal. A loud systolic ejection murmur is noted on physical exam. Chest X-ray demonstrates a “boot-shaped” heart. Which of the following is most likely the diagnosis?

By Yehuda Wolf, MPA, PA-C

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