Tetralogy of Fallot's present with one of the following –

Clinical features of TOF : Dyspnea on exertion and exercise intolerance → Most common. Cyanosis usually presents after the neonatal period Hypoxemic or cyanotic spells (Tet spells) Commonest congenital lesion with which squatting is used Clubbing Auscultatory findings : S1 →  Normal S2 →  Single predominantly Aortic Murmur →  Ejection systolic TOF patients are RARELY CYANOTIC AT BIRTH Chest x-ray Normal heart size Oligaemic lung fields Right aortic arch present in 25% case BOG → Right axis deviation, Inverted Twave, `P' pulmonale About option ‘b’ Pulmonary stenosis causes pressure overload → Concentric right ventricular hypertrophy without cardiac enlargement.