Which congenital heart defect is the most common cause of cyanotic congenital heart disease manifesting beyond the immediate neonatal period, characterized by ventricular septal defect, overriding aorta, pulmonary stenosis, and right ventricular hypertrophy?

Answer and explanation

Correct answer: C. Tetralogy of Fallot (TOF)

  1. Step 1: Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart anomaly beyond infancy.
  2. Step 2: It consists of four anatomical abnormalities: (1) large ventricular septal defect (VSD), (2) right ventricular outflow tract obstruction (pulmonary stenosis), (3) overriding aorta, and (4) secondary right ventricular hypertrophy.
  3. Step 3: Infants may experience hypercyanotic 'tet spells' relieved by squatting or knee-chest positioning.
Answer
Tetralogy of Fallot (TOF).
Why not the others: 'TGA' is the most common cyanotic lesion presenting in the first hours to days of life; 'Coarctation of the aorta' is acyanotic, featuring upper extremity hypertension and delayed femoral pulses; 'Tricuspid atresia' causes complete absence of the tricuspid valve with mandatory ASD/VSD.

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