Tetralogy of fallot chest xray

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Priyamvada Singh, M.B.B.S. [2], Keri Shafer, M.D. [3]; Assistant Editor-In-Chief: Kristin Feeney, B.S. [4]

Chest X Ray

In Tetralogy of Fallot, the heart may present with a "boot-like" or "coeur en sabot" appearance (an upturned right ventricular apex and a concave main pulmonary arterial segment), rather than the symmetric appearance of a normal heart. A right sided aortic arch may also be present. There is pruning or reduction in the prominence of the pulmonary vasculature over time.