radiological appearance of tetralogy of Fallot
Last reviewed 01/2018
Chest radiology may show a normal sized or enlarged heart but with the apex above the diaphragm due to right ventricular hypertrophy and a concave left heart border because the main pulmonary artery is small. The cardiac silhouette has been likened to a wooden shoe (coeur en sabot). The lung fields are oligaemic, and the aortic arch may be seen on the right in up to half. Summarising the features: PA lateral
- left atrium becomes enlarged, may see indentation carina splayed of oesophagus on barium swallow
- enlarged left enlarged heart, normal ventricle apex down
- enlarged right bulging right normal atrium heart border
- right upturned apex, raised heart ventricle boot shaped heart border