A 3-month-old infant is brought to the clinic for intermittent cyanosis, especially during feeding or crying spells. On examination, a harsh systolic ejection murmur is heard at the left upper sternal border. Chest X-ray shows a 'boot-shaped' heart. Which congenital heart defect is most likely present?
✓ Correct Answer: Option D
The classic presentation of Tetralogy of Fallot includes cyanotic spells (tet spells), a harsh systolic murmur from right ventricular outflow tract obstruction, and a 'boot-shaped' heart on CXR due to right ventricular hypertrophy.