Pentology of Fallot's presenting with complete heart block

PubMed, 2008

Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease, generally treated with total correction within the first two years of life. Occasionally, some unoperated cases can reach older ages. A 68-year-old woman with diabetes mellitus presented with swelling in legs and abdomen, weakness, exertional dyspnea, and orthopnea. On physical examination, she had mild cyanosis with clubbing. Her blood pressure was 110/60 mmHg and pulse rate was 79 beat/min. She had a systolic ejection murmur and bilateral rales on basal lung areas. Massive edema was noted in both lower limbs. Electrocardiography showed atrial fibrillation with normal ventricular response. Chest radiography showed an increased cardiothoracic ratio and bilateral minimal pleural effusion. Echocardiography showed biatrial dilatation (right atrium 62 mm, left atrium 49 mm) and thickening of left ventricular walls. There was right ventricular hypertrophy with decreased systolic function. A very large ventricular septal defect and severe pulmonary stenosis were noted. The patient did not accept any interventional procedure. To our knowledge, this is the oldest unoperated TOF case reported from our country.

Electronic Journal of General Medicine, 2010

Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease. This report describes the case of a fifty-one year old man who presents with an exertional dyspnea and polycythemia. Echocardiography showed perimembranous ventricular septal defect, hypertrophy of the right ventricle, overriding of the aorta and stenosis of the right ventricular outflow tract.

Journal of Clinical Medicine Research, 2009

An infant, showing peripheral cyanosis, was born after lower abdominal peripheral caesarian section of the pregnant women having TORCH positive test with the infection of Toxoplasma gondii and Cytomegalovirus. She had three abortions prior to this pregnancy. Doppler echocardiography of the baby showed profound intracardiac defects. After birth, echocardiography was carried out for diagnosis of associated cardiac anomalies. Doppler echocardiography showed pentalogy of Fallot, and the present case represents the Pentalogy of Fallot having pulmonary atresia. The baby's heart anomalies were ASD (Atrial Septal Defect-6 mm RT to LT Shunt), VSD (Ventricular Septal Defect-bidirectional shunt), PDA (Patent Ductus Arteriosus-filling both the pulmonary arteries), and Overriding of Aorta with pulmonary atresia. In conclusion, whenever the diagnosis pentalogy of fallot is suspected, a multidisciplinary approach is essential.

Pathology and laboratory medicine, 2021

In TOF the morphological abnormalities are-overriding of aorta, pulmonary obstruction, right ventricular hypertrophy and ventricular septal defect. Normally it is nonrestrictive means free communications between the ventricles but sometimes very rarely it can become restrictive when the tricuspid valve restrict the flow across the ventricular septal defect. Among children with CHD 10% of them report TOF. Chest radiographs usually show a normal-size heart silhouette, with an upturned apex and a concave main pulmonary artery segment, commonly known as "boot-shaped" heart. On the electrocardiogram, it is common to see signs of right atrial enlargement and right ventricular hypertrophy showing right axis deviation, prominent R waves anteriorly and S waves posteriorly, upright T wave in V1 (abnormal after 7 days of life up to 10 years of age) and a qR pattern in the right precordial leads. If the ration between pulmonary artery orifice diameter to aortic orifice diameter is <.3 primary repair is unsuccessful and in that case we must go for shunt surgeries which are palliative procedures till permanent repair can be done. This should add proper assessment of coronary artery origin. This is a case of adult tetralogy of fallot (TOF) coming to outpatient department of cardiology with complaints of chest discomfort and sometimes cyanotic spells. Age of the patient is 42 years male. Doppler Echocardiography was done. In the image overriding of aorta was found around 20% over interventricular septum. Left sided aortic arch was detected along with ventricular septal defect (VSD) with size 14 mm. Size of pulmonary orifice 10 mm and that of aortic orifice was 22 mm. Hence pulmonary artery orifice was found to get stenosed.

Journal of Medical Case Reports, 2013

Introduction: Tetralogy of Fallot is one of the most common forms of cyanotic congenital heart disease and in the absence of surgical correction it has an elevated early mortality, with most patients dying in childhood. The authors reported this case because of the unusual course of an uncorrected tetralogy of Fallot. There are only a few reports of patients with an uncorrected tetralogy of Fallot who reach an advanced age and to the best of our knowledge this is the first case report of a possible endocarditis in a patient with an uncorrected tetralogy of Fallot who is older than 70 years. Case presentation: The authors present a case of a 72-year-old Caucasian woman with uncorrected tetralogy of Fallot who was admitted with fever and heart failure to our Cardiology Department with possible infective endocarditis.

Pediatric cardiology, 2010

We present a large single-center series (&gt;2200 cases) operated for Tetralogy of Fallot (TOF). We analyzed the incidence of associated unusual and uncommonly described cardiac lesions and their diagnostic and therapeutic implications in TOF patients. This retrospective study was conducted by reviewing records of patients operated for TOF at a large tertiary care pediatric cardiac centre. From 2002 to 2008, a total of 2235 cases of TOF were evaluated with echocardiography, cardiac catheterization, and/or cardiac computed tomography followed by cardiac surgery. Known and well-described associations were excluded from the study. Unusual associations were tabulated. Several unusual associations having an incidence &gt;0.1% were detected. These included subaortic membrane (1%), pulmonary venous abnormalities (0.5%), small left ventricle (0.5%), interrupted inferior vena cava (0.5%), mitral valve abnormalities (0.4%), hemitruncus (0.4%), tricuspid valve abnormalities (0.4%), biventricul...

Cureus, 2020

Tetralogy of Fallot (ToF) is considered the most frequent cyanotic congenital heart abnormality with a low adulthood survival rate if kept untreated. The majority of cases are symptomatic during infancy and mandate early treatment. Few instances of survival to asymptomatic middle-age patients have been reported, and they are decreasing due to early detection. We reported a case of a middle-aged man who was asymptomatic during his life and recently diagnosed with ToF. The patient underwent surgical repair with excellent outcomes. The case represents the possibility of diagnosing such cases in a relatively old patient despite medical development and advances.

UKRAINIAN JOURNAL OF PERINATOLOGY AND PEDIATRICS

Tetrallogy of Fallot (ToF) is the most widespread congenital heart defect characterized by a wide anatomic spectrum and clinical manifestations, which depend on the degree of stenosis of the pulmonary artery, and can be associated with chromosomal abnormalities. Hypertrophic cardiomyopathy (HCM) is a rare genetic disorder that often occurs in the autosomal-dominant type and has a high risk of cardiac death and is associated with abnormalities in certain gene loci. Clinical case. We present this rare association in a 9-month-old girl, without previous history of heart defect, who was admitted to intensive care unit with a clinical presentation of severe hypoxic spell. A rare case of the combination of ToF and HCM has been reported in a 9-month-old child admitted to the reanimation department of the Lviv Regional Children’s Clinical Hospital «OKHMATDYT» for malignant and cyanotic attacks. The girl was hospitalized for reanimation in a jaundice-cyanotic crisis with a saturation rate of...

Journal of Thoracic Imaging, 2010

Tetralogy of Fallot (TOF) represents the most common form of cyanotic congenital heart disease, accounting for 6.8% of all congenital heart disease. As surgical techniques and medical management of patients with TOF have improved, most affected patients are reaching adulthood. Though surgical outcomes are favorable (<2% early mortality rate), adults with TOF may experience complications from the long-term sequelae of congenital heart disease and complications related to treatment. We describe common and uncommon findings in adults with TOF, including pulmonary insufficiency, central and peripheral pulmonary artery stenosis and aneurysms, in addition to graft and shunt-related complications. Pulmonary function abnormalities and lung parenchymal imaging findings will be detailed. The diagnostic value of computed tomography and magnetic resonance imaging in adults with complications of TOF will be illustrated.

Journal of Community Hospital Internal Medicine Perspectives

Tetralogy of Fallot is the most common cyanotic congenital heart disease. It consists of right ventricular outflow tract obstruction, a ventricular septal defect, abnormally located aorta and right ventricular hypertrophy. It usually occurs as an isolated anomaly with a normally placed heart and abdominal viscera. We present a case of a 19 years old female who presented with a prolonged history of shortness of breath (SOB) and cyanosis. After undergoing echocardiography and cardiac computed tomography angiogram (CTA), she was diagnosed to be a case of Tetrology of Fallot (TOF) in association with situs inversus with levocardia also termed 'isolated levocardia'. The patient underwent surgical correction and she was asymptomatic with no residual cardiac defects on follow up after 6 months. Isolated levocardia is a rare condition that is usually associated with severe cardiac defects and a low life expectancy in untreated patients. It is unusual for it to be diagnosed in adults as in our case.