In TOF the morphological abnormalities are –overriding of aorta, pulmonary obstruction, right ventricular hypertrophy and ventricular septal defect. Normally it is nonrestrictive means free communications between the ventricles but sometimes very rarely it can become restrictive when the tricuspid valve restrict the flow across the  ventricular septal defect.TOF accounts for approximately 10% of children with CHD.This is a case of adult tetralogy of fallot (TOF) coming to outpatient department of cardiology with complaints of chest discomfort and sometimes cyanotic spells. Age of the patient is 42 years male. Doppler Echocardiography was done . In the image overriding of aorta was found around 20% over   interventricular septum. Left sided aortic arch was detected along with ventricular septal defect (VSD) with size 14 mm. Size of pulmonary orifice 10 mm and that of aortic orifice was 22 mm.Hence pulmonary artery orifice was found to get stenosed.

Keywords: Tetralogy, Aorta, Artery, Orifice, Ventricle, Chest