Tetralogy of Fallot (TOF) is a congenital heart defect that is one of the most common causes of cyanotic heart disease in neonates. It is characterized by four key anatomical abnormalities: ventricular septal defect (VSD), pulmonary stenosis, right ventricular hypertrophy, and an overriding aorta. These defects result in oxygen-poor blood being pumped out of the heart and into the systemic circulation, leading to cyanosis, or a bluish tint to the skin.