Tetralogy of Fallot (TOF) is the most common cyanotic heart disease. It consists of 4 defects in the heart of the child (tetralogy): Pulmonary Stenosis and Infundibular Stenosis (obstruction to right ventricular outflow due to narrowing of one or more points from right ventricle to Pulmonary artery). Ventricular Septal Defect (VSD)- Abnormal opening or hole in the septum between the two ventricles. Overriding of Aorta over the VSD- The Aorta is placed over the VSD, instead of being over left ventricle. Right Ventricular Hypertrophy: abnormal enlargement of heart muscle of right ventricle. Blood is shunted from right side of heart to left side of heart with varying degrees of cyanosis. If mild, patient may not have visible cyanosis- known as Pink TOF. With severe disease, cyanosis is visible in neonatal period- known as Ductal Dependent TOF. Clinical Features: Cyanosis: Bluish discoloration of skin due to inadequate oxygenation of blood. Rapid breathing or dyspnea while feeding or exe
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