Which of the following is a component of Tetralogy of Fallot?

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Tetralogy of Fallot is defined by four heart defects, one of which is obstruction of the right ventricular outflow tract, typically described as pulmonary stenosis. This narrowing at or just below the pulmonary valve raises the pressure in the right ventricle and promotes right-to-left shunting across the ventricular septal defect, which is the hallmark cyanotic feature of the condition and underlies the characteristic “tet spells.” Among the options, pulmonary valve stenosis fits as a component because it directly contributes to the outflow obstruction that drives the pathophysiology of TOF. The other choices are not part of TOF: mitral valve prolapse and aortic regurgitation are separate valvular diseases, and an atrial septal defect is a defect between the atria, not the ventricles. In TOF, the four classic abnormalities are a ventricular septal defect, right ventricular outflow tract obstruction (pulmonary stenosis), an overriding aorta, and right ventricular hypertrophy.