MCQ Cardiology Answer 26

The Correct Answer is E


In T.O.F.

Roentgenogrophic examination characteristically reveals a normal-sized, boot-shaped heart (“coeur en sabot”) with prominence of the right ventricle and a concavity in the region of the underdeveloped right ventricular outflow tract and main pulmonary artery. The pulmonary vascular markings typically are diminished, and the aortic arch and knob may be on the right side; the ascending aorta usually is large. A uniform, diffuse, fine reticular pattern of vascular markings is noted in the presence of prominent collateral vessels.

The degree of obstruction to pulmonary blood flow is the principal determinant of the clinical presentation. The site of obstruction is variable. Infundibular stenosis is the only major obstruction in about 50% of patients and coexists with valvular obstruction in another 20 to 25 per cent. Supravalvular and peripheral pulmonary arterial narrowing may be observed, and unilateral absence of a pulmonary artery (usually the left) is found in a small number of patients. Circulation to the abnormal lung is accomplished by bronchial and other collateral arteries.

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