Tetralogy of Fallot - Right aortic arch
The lifted up apex (cor en sabot – peasant’s boot shaped heart) due to the right ventricular hypertrophy is seen well in this chest X-ray PA view. The right sided aortic arch is seen intending the tracheal air column on the right side. There is mild cardiomegaly and right atrial enlargement as well in this adult person with tetralogy of Fallot and associated inferior wall myocardial infarction. The lung fields are oligemic due to the right ventricular outflow tract obstruction in Tetralogy of Fallot. Tetralogy of Fallot is the commonest cause of right aortic arch in an adult.