ABSTRACT
Sir William Osier 1 (1849–1919) attributed the term ‘coeur en sabot,’ used to describe the shape of the heart in cases of tetralogy of Fallot, to Henri Vaquez and E. Border. ‘The most characteristic roentgen-ray features are the relatively small size of the left ventricle and the great hypertrophy of the right ventricle, which frequently curves around the smaller left chamber from below, rising upward like the tip of a sabot (Vaquez and Bordet), and giving rise to the descriptive term ‘coeur en sabot’, which is characteristic of the more pronounced cases associated with ventricular septal defect and dextroposition of the aorta.’ 1 Vaquez (1860–1936) was a professor of the Faculty of Medicine in Paris and Bordet (1888–1925) was the chief of the laboratory. In Vaquez and Bordet’s 1920 book 2 , The Heart and the Aorta, the term is actually used in the discussion of ‘Simple Stenosis of the Pulmonary Artery; The orthodiagraphic tracing … presents the characteristic form known as ‘en sabot’: the heart apex is pushed outward and elevated’ 2 (Figure 1). The term is not used in cases of pulmonary stenosis with interventricular communication, although these are two of the features of Fallot’s tetralogy. Indeed, the authors did not mention their countryman, Etienne Fallot (1850–1911), even though his description of the four cardinal features of the cyanotic congenital heart disorder that now bears his name appeared in 1888 3 . Despite the apparent misappropriation by Osier, the term is now firmly associated with the shape of the cardiac silhouette seen in patients with the tetralogy of Fallot (Figure 2). Boot-shaped heart showing ‘Pulmonary Stenosis: p, apex of the left heart; p’, apex of the right heart. (Coeur ensabot).’ Reprinted from <italic>The Heart and the Aorta</italic> by Vaquez and Bordet (1920)<sup>!</sup>. Translated by Honeij J A and Macy J., with permission of the publisher, Yale University Press https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9781003076568/34c29fd5-5662-4e8f-b58c-badd7fa5d724/content/fig7_1_B.jpg"/> Chest radiograph of child with tetralogy of Fallot. Case courtesy of Dr P. Haney, University of Maryland https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9781003076568/34c29fd5-5662-4e8f-b58c-badd7fa5d724/content/fig7_2_B.jpg"/>
