pediatrics
Tetralogy of Fallot
Diagnosis of Tetralogy of Fallot
Chest x-ray and ECG Echocardiography Diagnosis of tetralogy of Fallot is suggested by history and clinical examination, supported by chest x-ray and ECG, and established by 2-dimensional echocardiography with color flow and Doppler studies. Chest x-ray shows a boot-shaped heart with a concave main pulmonary artery segment and diminished pulmonary vascular markings. A right aortic arch is present in 25%. ECG shows right ventricular hypertrophy and right axis deviation and may also show right atrial enlargement. Cardiac catheterization is rarely needed, unless there is suspicion of a coronary artery anomaly that might affect the surgical approach (eg, anterior descending arising from the right coronary artery) that cannot be clarified with echocardiography. MRI or CT may also be used to demonstrate coronary artery anatomy. 