A two–year old boy present with episodes of becoming dusky. On examination, there was central cyanosis and clubbing. There was no pallor, oedema or respiratory distress. The heart was normal sized with a parasternal heave. A systolic thrill was palpable over the left middle sternal border. First heart sound was normal and only the aortic component was audible in the second heart sound. Liver was not enlarged – What would be the likely diagnosis –
High-Yield Explanation
Features in this child suggestive of TOF : -
Cyanosis at 2 year (not at birth)
No pallor, dysnea or edema —> No CHF
Normal sized heart
These features suggest the diagnosis of TOF.
These have been explained earlier.