case_images: PMC10869317_01
case_images: EKG showing normal sinus rhythm, bi-atrial enlargement, right bundle branch block, and left posterior fascicular block
case_images: cureus-0016-00000052407-i01.jpg
case_images: PMC10869317_01_cureus-0016-00000052407-i01.jpg
case_images: FIG1
case_images: An electrocardiogram showed normal sinus rhythm, bi-atrial enlargement, a right bundle branch block, and a left posterior fascicular block (Figure 1).
case_images: CXR and CT chest showing boot-shaped heart
case_images: cureus-0016-00000052407-i02.jpg
case_images: PMC10869317_01_cureus-0016-00000052407-i02.jpg
case_images: FIG2
case_images: The chest X-ray demonstrated an enlarged "boot-shaped" heart (Figure 2).
case_images: Echocardiogram showing VSD, overriding aorta, and right ventricular hypertrophy
case_images: cureus-0016-00000052407-i03.jpg
case_images: PMC10869317_01_cureus-0016-00000052407-i03.jpg
case_images: FIG3
case_images: An echocardiogram confirmed the diagnosis of TOF, showing an enlarged overriding aorta, right ventricular outflow tract obstruction, right ventricular hypertrophy, and large peri-membranous ventricular septal defect (Figures 3, 4), with a right-to-left shunt consistent with Eisenmenger syndrome.
case_images: Echocardiogram with color doppler showing right-to-left shunt VSD
case_images: cureus-0016-00000052407-i04.jpg
case_images: PMC10869317_01_cureus-0016-00000052407-i04.jpg
case_images: FIG4
case_images: An echocardiogram confirmed the diagnosis of TOF, showing an enlarged overriding aorta, right ventricular outflow tract obstruction, right ventricular hypertrophy, and large peri-membranous ventricular septal defect (Figures 3, 4), with a right-to-left shunt consistent with Eisenmenger syndrome.