A Case of Uncorrected Tetralogy of Fallot Undiagnosed Until Adulthood and Presenting With Polycythemia

Gündüz, Ercan; Gorgel, Ahmet; Dursun, Recep; Durgun, Hasan Mansur; Çil, Habip; İçer, Mustafa; Zengin, Yılmaz

doi:10.14740/cr374e

Cited by 9 publications

(7 citation statements)

References 6 publications

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“…Despite an increased Hb level, erythropoietin-mediated and hypoxia-dependent polycythemia is characterized by an elevated erythropoietin level (Sirhan et al, 2005). In the study of (Gunduz et al, 2014), the results found an increase in the RBC 7 × 10 6 /μL, PCV 64.4%, Hg 21.5 g/dL in adult females with uncorrected TOF. A physiological reaction to tissue hypoxia is secondary erythrocytosis associated with cyanotic congenital heart disease, resulting in a rise in serum erythropoietin level, stimulating bone marrow erythropoiesis, resulting in increased red cell mass, PCV, and viscosity of the whole blood (Territo andRosove, 1991, Warrell et al, 2003).…”

Section: Discussionmentioning

confidence: 89%

Arterial blood gases and some blood parameters in Tetralogy of Fallot patients

Ameen¹

2021

ZJPAS

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The present study was done to assess the effect of the tetralogy of Fallot (TOF) on some arterial blood measurements including pH, the partial pressure of carbon dioxide (PaCO2), the partial pressure of oxygen (PaO2), Base excess (BE), Red blood cells (RBC), Packed cell volume (PCV), and Hemoglobin (Hb) concentration in the Erbil City of Iraq. For this purpose 80 (40 males and 40 females) patients with (TOF) and aged between 3-33 years were used in this study. This retrospective cohort study was conducted from March /2018 to October 2020 and carried out in the Surgeries Hospital Specialist -Cardiac Center in Erbil city. The studied parameters were estimated before and two to three weeks after postoperative correction of TOF. A dependent ttest was used for data analysis. The results showed that males and females with (TOF) after surgical correction have significantly p≤ 0.001 lower PaCO2, RBC, PCV, and Hb concentration, while the concentration of PaO2 and the value of BE were significantly p≤ 0.001 higher after surgical correction in comparison with the value before surgery. Moreover, males showed a significantly higher concentration of RBC, PCV, and hemoglobin than females after surgical correction. Conclusions: Surgery repair of (TOF) restore the arterial blood measurements PaCO2, PaO2, BE, RBC, PCV, and Hb concentration to the normal value in males and females.

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Section: Discussionmentioning

confidence: 89%

Arterial blood gases and some blood parameters in Tetralogy of Fallot patients

Ameen¹

2021

ZJPAS

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“…Chronic hypoxemia due to right to left shunt leads to polycythaemia and consequently increased viscosity of blood. 2 Infective endocarditis and brain abscess are uncommon presentations of tetralogy of Fallot. 3,4 Although these two are uncommon presentations, they are serious and require prolonged hospitalization and treatment, and poses threat to life.…”

Section: Introductionmentioning

confidence: 99%

Brain abscess in older children with uncorrected tetralogy of Fallot

Prasad

Prasad²,

Azad³

2023

Int J Contemp Pediatr

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Tetralogy of Fallot is the most common cyanotic congenital heart disease. Corrective surgery is indicated during infancy for the best outcome, however, due to poor availability and affordability of surgery, many children of resource-poor settings live with uncorrected tetralogy of Fallot. They suffer from dreaded complications like brain abscess, in later years of life. We report 3 cases of tetralogy of Fallot who developed brain abscess during their childhood.

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“…If undetectable, Doppler ultrasound examinations should be performed and followed by multidetector computed tomography angiography or magnetic resonance-angiography. In addition, we would recommend that such patients undergo specific assessments for congenital heart diseases, such as tetralogy of Fallot [ 11 ], pulmonary stenosis [ 12 ], transposition of the great arteries [ 13 ] and other extra cardiac congenital diseases. Late diagnosis, due to the clinician’s lack of awareness of the disorder, can expose the patient to the risk of major complications and impaired long-term survival.…”

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confidence: 99%

Failing to palpate femoral pulses in adult hypertensive patients may lead to diagnostic wandering and major cerebrovascular events in cases of undetected aortic coarctation

et al. 2022

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In developed countries, aortic coarctation (AC) is generally diagnosed by fetal echocardiography during the third trimester of pregnancy, or during the neonatal period based on the absence of femoral pulses or the presence of a left supraclavicular systolic murmur. However, AC may be diagnosed late, such as in adult migrants arriving from developing countries without documented medical history although they may require healthcare support during their stay. We report three cases of the incidental diagnosis of thoracic aortic malformations in adults (27, 38 and 43 years) referred for the management of uncontrolled high blood pressure, with major cerebrovascular events for the two oldest. Doppler ultrasound imaging indicated for suspected renal artery stenosis and atheroma lesions revealed abnormal lower-body and normal upper-body arterial blood flow velocity waveforms constitutive of a pathognomonic hemodynamic pattern of AC, a diagnostic which was in all three cases confirmed by multidetector computed tomography-angiography. None of these patients had undergone complete cardiovascular examination, particularly with effective peripheral pulse palpation, during the period preceding the occurrence of major cardiovascular events or at any other time after birth. Our observation suggests that a simple medical examination could have prevented diagnostic wandering and, possibly, the occurrence of severe cerebrovascular complications in two of these three patients.

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A Case of Uncorrected Tetralogy of Fallot Undiagnosed Until Adulthood and Presenting With Polycythemia

Cited by 9 publications

References 6 publications

Arterial blood gases and some blood parameters in Tetralogy of Fallot patients

Arterial blood gases and some blood parameters in Tetralogy of Fallot patients

Brain abscess in older children with uncorrected tetralogy of Fallot

Failing to palpate femoral pulses in adult hypertensive patients may lead to diagnostic wandering and major cerebrovascular events in cases of undetected aortic coarctation

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