In which area is the murmur of Tetralogy of Fallot best heard?

The murmur associated with Tetralogy of Fallot is most prominently heard at the left sternal border due to the anatomical issues involved in the heart's structure. This congenital heart defect consists of four components: ventricular septal defect (VSD), right ventricular outflow tract obstruction (RVOT), aortic override, and right ventricular hypertrophy.

Because a significant component of this condition is the narrowing of the outflow tract from the right ventricle, the turbulent blood flow can often be best appreciated in that area. The left sternal border is particularly sensitive to such sounds, making it the most effective location for auscultation in patients with Tetralogy of Fallot. This positioning allows healthcare providers to detect the characteristic, often loud, harsh systolic ejection murmur that indicates the presence of the RVOT obstruction.

Other options, while they may result in some heart sounds or murmurs, do not capture the distinctive characteristics of the Tetralogy of Fallot murmur as effectively as the left sternal border.