Late Discovery: Uncovering Tetralogy of Fallot in Adulthood-A Case Report

Abstract

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 report the case of a 44-year-old trisomic male, with poor socioeconomic conditions, with an illness-free past medical history presented for preoperative cardiac assessment for cholecystistis. Tetralogy of Fallot was fortuitously discovered and the patient underwent total correction of ToF. In the immediate post-operative period; the patient presented a complete atrioventricular block, for which a double chamber pacemaker was implanted.  Echocardiographic follow-up showed no residual shunt, no pulmonary insufficiency. Our patient had an excellent post-operative and six-months follow-up profile. Thorough physical examination of newborns and a screening echo in the early life may aid in detecting the disease earlier.