Pediatric Cardiology

, Volume 33, Issue 4, pp 666–668 | Cite as

Tetralogy of Fallot With Infective Endocarditis: An Echocardiographic Explanation of Misleading Clinical Signs

  • Pravin K. Goel
  • Nagaraja MoorthyEmail author
  • Tanuj Bhatia
Images in Pediatric Cardiology


Echocardiography has a known key role in the diagnosis of infective endocarditis, the diagnosis of complications, follow-up evaluation after therapy, and prognostic assessment Habib (Eur J Echocardiogr 11:202–219, 3). This report describes a boy with tetralogy of Fallot who presented with infective endocarditis and large vegetation occluding the ventricular septal defect, thus resulting in a hemodynamically restrictive ventriculoseptal defect with misleading clinical signs. This case illustrates the role of echocardiography in both explaining clinical signs and providing hemodynamic data.


Echocardiography Infective endocarditis Tetralogy of Fallot 

Supplementary material

Video 1 (A) Transthoracic echocardiography showing a large perimembranous ventriculoseptal defect (VSD) with overriding of the aorta. (B) Transthoracic echocardiography showing anterocephalad deviation of the conus septum together with severe infundibular stenosis. (C) Transthoracic echocardiography in color Doppler showing severe infundibular and valvular pulmonary stenosis. Supplementary material 1 (AVI 1832 kb)

Supplementary material 2 (AVI 1839 kb)

Video 2 (A) Transthoracic echocardiography showing large vegetation partially obstructing the ventriculoseptal defect (VSD). (B) Transthoracic color Doppler image in parasternal long axis showing right-to-left shunting across a hemodynamically restrictive VSD. Supplementary material 3 (AVI 1637 kb)

Supplementary material 4 (AVI 1607 kb)

Supplementary material 5 (AVI 1840 kb)


  1. 1.
    Anwar AM, Nosir YF, Anjam A et al (2008) Multivalvular infective endocarditis in a tetralogy of Fallot. Echocardiography 25:88–90PubMedGoogle Scholar
  2. 2.
    Dodds GA, Durack DT (1995) Criteria for the diagnosis of endocarditis and the role of echocardiography. Echocardiography 12:663–668PubMedCrossRefGoogle Scholar
  3. 3.
    Habib G, Badano L, Tribouilloy C et al (2010) Recommendations for the practice of echocardiography in infective endocarditis. Eur J Echocardiogr 11:202–219PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Pravin K. Goel
    • 1
  • Nagaraja Moorthy
    • 1
    Email author
  • Tanuj Bhatia
    • 1
  1. 1.Department of CardiologySanjay Gandhi Postgraduate Institute of Medical SciencesLucknowIndia

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