Question

Boot shape of heart in TOF is due to:

• A. Left atrial enlargement
• B. Right atrial enlargement
• C. Right ventricular hypertrophy
• D. Biventricular hypertrophy

Answer 1

The Correct Option is C

The "boot shape" appearance of the heart in Tetralogy of Fallot (TOF) is primarily due to Right Ventricular Hypertrophy. This condition causes the right ventricle to enlarge, which leads to the upturning of the heart's apex, creating the characteristic boot-shaped silhouette observed in chest X-rays. Understanding this involves a comprehension of the anatomical changes associated with TOF:

1. Right Ventricular Hypertrophy: The increased workload on the right ventricle, due to obstruction in the pulmonary outflow tract, leads to its hypertrophy. This hypertrophy alters the heart's shape, contributing to the boot appearance.
2. Pathophysiology: Tetralogy of Fallot is a congenital heart defect comprising four key features: ventricular septal defect (VSD), pulmonary stenosis, right ventricular hypertrophy, and aortic override. Among these, right ventricular hypertrophy is the factor responsible for the boot-shaped heart.