Tetralogy of fallot:

A cyanotic congenital heart disease characterized by right ventricular hypertrophy, pulmonary stenosis, ventricular septal defect (VSD), and dextroposition of the aorta.

• X-ray: boot-shaped (coeur en sabot)
  
  • concavity of L cardiac border (no PA)
  • normal heart size
  • RVH -> elevation of apical shadow
• diminished pulmonary vascularity
• aortic arch to R in 20%