Tetralogy of Fallot, Small Pulmonary Annulus, and Low Nakata Index

  • Hakimeh Sadeghian
  • Zahra Savand-Roomi


A 23-year-old man presented with dyspnea on exertion (functional class III), hemoptysis, and cyanosis. Physical examination revealed severe cyanosis (O2 saturation of 76 % in air room) as well as a systolic ejection murmur in the pulmonic area at the left sternal border. He had undergone surgery at childhood for a shunt. The electrocardiogram showed right-axis deviation and right ventricular hypertrophy.

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  1. 102.
    Rudolph AM. Pulmonary stenosis and atresia with ventricular septal defect (Tetralogy of Fallot). In: Rudolph AM, editor. Congenital disease of the heart. New York: Futura Publishing Company; 2001. p. 489–549.Google Scholar
  2. 103.
    Roche SL, Greenway S, Redington AN. Tetralogy of Fallot with pulmonary stenosis and Tetralogy of Fallot with absent pulmonary valve. In: Allen HA, Driscoll D, Shaddy RE, Feltes TF, editors. Moss and Adams’ heart disease in infants, children, and adolescents. 8th ed. Philadelphia: Lippincott Williams & Wilkins; 2013. p. 969–89.Google Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • Hakimeh Sadeghian
    • 1
  • Zahra Savand-Roomi
    • 2
  1. 1.Department of EchocardiographyTehran University of Medical Sciences Tehran Heart CentreTehranIran
  2. 2.Department of EchocardiographyKowsar HospitalShirazIran

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