Unrepaired Tetralogy of Fallot in Adulthood

This case report describes a 29-year-old man with longstanding exertional dyspnea, visual blurring, and headaches who was diagnosed with tetralogy of Fallot after immigrating to the United States. Imaging revealed classic features: overriding aorta, large ventricular septal defect, right ventricular hypertrophy, and subpulmonic stenosis. Clinical signs included a harsh holosystolic murmur and high hemoglobin levels; symptoms improved with squatting due to reversal of right-to-left shunting. Surgical repair involved pulmonary valvotomy, VSD closure, resection of obstructive muscle bundles, and infundibular patching. Postoperatively, the patient showed marked symptomatic improvement.

This case report describes a 29-year-old man with longstanding exertional dyspnea, visual blurring, and headaches who was diagnosed with tetralogy of Fallot after immigrating to the United States. Imaging revealed classic features: overriding aorta, large ventricular septal defect, right ventricular hypertrophy, and subpulmonic stenosis. Clinical signs included a harsh holosystolic murmur and high hemoglobin levels; symptoms improved with squatting due to reversal of right-to-left shunting. Surgical repair involved pulmonary valvotomy, VSD closure, resection of obstructive muscle bundles, and infundibular patching. Postoperatively, the patient showed marked symptomatic improvement.