Final answer:
A boot-shaped heart on CXR should make you think of Tetralogy of Fallot, a congenital heart defect characterized by four specific abnormalities. The boot-shaped appearance is due to right ventricular hypertrophy. CXR findings should be confirmed with other clinical features and diagnostic tests.
Step-by-step explanation:
The diagnosis that comes to mind when seeing a boot-shaped heart on a chest X-ray (CXR) is Tetralogy of Fallot. Tetralogy of Fallot is a congenital heart defect characterized by four anatomical abnormalities: a ventricular septal defect, overriding aorta, pulmonary stenosis, and right ventricular hypertrophy. These abnormalities cause blood to bypass the lungs and result in reduced oxygen levels in the blood.
The boot-shaped appearance of the heart on the CXR is due to the right ventricular hypertrophy, which causes the heart to become enlarged and shaped like a boot.
It is important to note that the CXR findings should be correlated with other clinical features and diagnostic tests to confirm the diagnosis.