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The definitive diagnostic test for Tetralogy of Fallot is:

  1. Cardiac catheterization
  2. Doppler Echocardiography

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.


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