Uncorrected Tetralogy of Fallot – a case report of a 69-year-old patient

Czech version

Authors: Naďa Hučková ^1,2; Katarína Sekurisová ¹; Laura Slezáková ^1,2; Katarína Kusendová ²; Andrej Zachar ¹; Mária Szántová ¹
Authors‘ workplace: III. interná klinika LF UK a UN Bratislava, Slovenská republika, prednosta doc. MUDr. Viliam Mojto, CSc., MHA ¹; II. interná klinika LF UK a UN Bratislava, Slovenská republika, prednosta doc. MUDr. Ľudovít Gašpar, CSc. ²
Published in: Vnitř Lék 2015; 61(12): 1088-1092
Category: Case Reports

Overview

Tetralogy of Fallot (ToF) is the most common cyanotic congenital heart defect. The actual treatment relies on cardio-surgery – complete correction within the infant age. Without surgery only 10 % of subjects survived 3^rd decade and only 3–5 % of subjects were able to survive until their 40^th. This particular paper is dedicated to case of a 69-years old male subject with positive history of uncorrected ToF due to his refusal of surgery, ischemic cardiac disease NYHA III–IV and chronic kidney failure. This subject was hospitalized within the department of internal medicine due to several days of chest pain connected with lower extremities oedemas and dyspnoeic syndrome after minimal physical load. Provided echocardiography revealed pulmonary artery stenosis, severe tricuspid insufficiency, concentric hypertrophy of ventricles, ventricular septal defect, dextroposition of aorta and severe pericardial effusion. Chest X-ray proved massive pleura effussion. The actual conditions of subject improved significantly after onset of diuretics, antiarrhytmics and providing of pleural punction. Subject has been discharged. Cases of ToF presented within available sources in older population were associated with left ventricular hypertrophy and hypoplastic pulmonary artery and slow subpulmonal obstruction development which also presented within our subject. Left ventricular hypertrophy has a potential to develop continuously and therefore its benefits can be visible within adult age.

Keywords:
adulthood – surgery – tetralogy of Fallot

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