[Table/Fig-3a]:

TOF Severe outflow obstruction.

A three-month-old female presented with cyanosis on feeding, diagnosed as Tetralogy on echocardiography, confirmed on MDCT examination; (a) Diagrammatic representation of cardiac anatomy in TOF; (b) Plain radiograph shows moderate cardiac enlargement with upturned apex (RV configuration) (triangle) and decreased pulmonary arterial markings; (c) Echocardiography long axis view demonstrates a large malaligned perimembraneous VSD (arrow); (d) Colour Doppler examination of RV outflow demonstrates narrowing of pulmonary artery with turbulent flow.