Fallot’s tetralogy in an adult patient. Apropos of a case

Abstract

Fallot's tetralogy amounts to 10 % of all the congenital cardiopathies. It is the most frequent cyanogenic congenital cardiopathy in adults, with a 5,8 % incidence at birth, but only 6 % of the non-operated patient lives at the age of 30 years, and 3 % at the age of 40. After making the clinical record of the female patient and the necessary complementary examination, we reviewed the literature and compared the findings, specially the evolution, with the facts described by other authors. We present the MDCC patient, aged 48 years with clinical record Nr 18605, entering the service on February 21st, 2013, for lack of breath of 4 days of evolution, with a tendency to increase when exercising or when walking long distances, and that do not alleviate when changing position. We also describe that the same day we began to notice feet swelling, without a cyanotic coloration or cough, expectoration or fever accompaniment. Physical examination showed positive findings. Cardiovascular tract: rhythmic cardiac noise of good tonus and intensity; we auscultated a systolic pulmonary blow III/VI, irradiating to the rest of the pre cordial area. Laboratory analysis and available imaging examination (Thoracic Rx, thoracic contrasted computerized tomography, Doppler echocardiogram) were carried out. We physio-pathologically analyzed the patient's symptoms and her survival (including two pregnancy, one of them a term pregnancy) without being operated and without an adequate follow. Although the survival of the patients with Fallot¡'s  tetralogy after they are 40 years old is low, some of them, like the studied patient, achieve it and with good life quality, it does not mean that they might not present several diseases, like right or congestive cardiac insufficiency, arrhythmia and endocarditis.