Tetralogy of Fallot (TOF) represents a prevalent congenital cardiac anomaly characterized by a constellation of four primary pathological features, alongside a spectrum of secondary morphological and functional anomalies. The cardinal components include an overriding aorta, a membranous ventricular septal defect (VSD), right ventricular hypertrophy, and right ventricular outflow tract (RVOTO) obstruction. The clinical prognosis of TOF is predominantly influenced by the degree of RVOTO, which modulates the degree of right-to-left shunting and subsequent systemic desaturation. Epidemiological studies indicate that survival beyond the fifth decade of life is possible, irrespective of surgical intervention, underscoring the variability in disease severity and management outcomes. Cyanosis, a hallmark of TOF, typically manifests within the first year of life if not present at birth. In cases where the RVOTO is mild and the VSD exhibits a balanced configuration, cyanotic episodes may be absent, a phenotype referred to as "Pink Tetralogy of Fallot." This presentation is associated with reduced right-to-left shunting due to preserved pulmonary blood flow. The present case describes a 12-year-old female of Indian origin diagnosed with Pink Tetralogy of Fallot, attributed to mild aortic overriding. A comprehensive echocardiographic assessment, including transthoracic color Doppler imaging, was conducted to delineate the anatomical and hemodynamic features of the condition.
1*Akhil Mehrotra, 2Mohammed Shaban, 3Saadia Salamat (Sun,) studied this question.