Rapid Review: 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: PROVe: Pulmonic 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?
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