Question:
Identify the condition in the X-ray given below.
Identify the condition in the X-ray given below.
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Upturned apex, concave pulmonary bay, dark lungs, think of the shape of a boot.
Updated On: Jun 23, 2026
- TGA
- TAPVC
- TOF
- Ebstein's anomaly
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Verified By Collegedunia
The Correct Option is C
Solution and Explanation
Step 1: Read the cardiac silhouette. The heart has an upturned apex with a concave (scooped-out) main pulmonary artery segment, giving the classic 'boot-shaped' heart (coeur en sabot).
Step 2: Read the lung fields. They look dark and oligaemic, reflecting reduced pulmonary blood flow.
Step 3: Combine. A boot-shaped heart with poorly developed lung vasculature is the textbook chest radiograph of Tetralogy of Fallot (TOF). Diagnosis is confirmed on echocardiography, and surgical correction is usually done at 4 to 6 months of age.
Why the others are wrong: Transposition of the great arteries (TGA) gives an 'egg-on-side' shape with a narrow pedicle. TAPVC (supracardiac) gives a 'snowman' or figure-8 cardiac shadow with increased pulmonary vascularity. Ebstein's anomaly gives a massively enlarged, box-shaped heart.
Ref: Bailey and Love, Short Practice of Surgery, 27th edition, Page 905.
Step 2: Read the lung fields. They look dark and oligaemic, reflecting reduced pulmonary blood flow.
Step 3: Combine. A boot-shaped heart with poorly developed lung vasculature is the textbook chest radiograph of Tetralogy of Fallot (TOF). Diagnosis is confirmed on echocardiography, and surgical correction is usually done at 4 to 6 months of age.
Why the others are wrong: Transposition of the great arteries (TGA) gives an 'egg-on-side' shape with a narrow pedicle. TAPVC (supracardiac) gives a 'snowman' or figure-8 cardiac shadow with increased pulmonary vascularity. Ebstein's anomaly gives a massively enlarged, box-shaped heart.
Ref: Bailey and Love, Short Practice of Surgery, 27th edition, Page 905.
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