Diagnosis

The definitive diagnostic test for Tetralogy of Fallot is:

1. Cardiac catheterization
2. Doppler Echocardiography

A presumptive diagnosis can be made with:

1. Systemic cyanosis.
2. Radiographic evidence of pulmonary undercirculation and right heart enlargement
3. Electrocardiographic evidence of right ventricular enlargement.

Results of Diagnostic Tests:

1. Radiology may show:
   • Criteria for right ventricular enlargement
   • Pulmonary undercirculation
   • Main pulmonary artery may be small
2. ECG may show:
   • Criteria for right ventricular enlargement
   • Ventricular ectopy
3. Blood Work may show:
   • Polycythemia
   • Evidence of reduced glomerular filtration (increase BUN/creatinine)
4. Echocardiography: may show:
   • Right ventricular hypertrophy
   • Doppler evidence of pulmonic stenosis
   • Overriding aorta
   • High ventricular septal defect
   • Color Doppler or contrast echocardiographic evidence of a right to left shunt.

Comment:

• pulmonary artery hypoplasia is common
• anomalies of the aorta are common