Tetralogy of fallot is a congenital heart anomaly with following components: 1. Pulmonary stenosis 2. Ventricular septal defect 3. Over-riding of aorta 4. Right ventricular hypertrophy It presents with cyanosis, dyspnea, failure to thrive, irritability, fainting and ejection systolic murmur with lift parasternal heave. The condition is diagnosed using EKG, Echocardiogram, chest X-ray and cardiac catheterization. Picture credit: https://www.mayoclinic.org/diseases-conditions/tetralogy-of-fallot/symptoms-causes/syc-20353477