Which congenital heart defect is characterized by the classic 'boot-shaped heart' (coeur en sabot) on chest radiograph and presents with hypoxic cyanotic spells ('tet spells')?
Answer and explanation
Correct answer: A. Tetralogy of Fallot
- Step 1: Tetralogy of Fallot is the most common cyanotic congenital heart lesion, consisting of VSD, pulmonary stenosis, overriding aorta, and right ventricular hypertrophy.
- Step 2: Right ventricular hypertrophy elevates the cardiac apex, producing the characteristic 'boot-shaped' cardiac silhouette on X-ray.
Answer
Tetralogy of Fallot.
Why not the others: 'Transposition of the great arteries' demonstrates an 'egg on a string' cardiac silhouette; 'Coarctation of the aorta' shows a 'figure-of-3' sign on plain film and rib notching; 'Patent ductus arteriosus' causes left heart enlargement and increased pulmonary vascular markings.
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