Indian Journal of Emergency Medicine

Background: Tetralogy of Fallot (TOF) is recognized as the predominant form of cyanotic congenital heart disease beyond infancy. Grasping the dynamic factors that either exacerbate or ameliorate the shunt represents the cornerstone for managing critically ill patients with TOF in an emergency department (ED). Case description: We herein document a 29-year-old uncorrected TOF patient who manifested symptoms of acute gastroenteritis & respiratory failure. A provisional diagnosis was then formulated сonnectіng aсute gastroenteritis to a provoked hyрoxіс spell with uncorrected TOF. Suррortіve сare was provided that led to positive outcome. Clinical relevance: This case study elucidates the clinical dilemmas in managing a critically ill, uncorrected TOF individual dealing with the complex interplay of physiology and biochemical changes. Attention to comprehensive management of a Tet spell is thereby underscored. Information suggests this situation represents a rare case of a few surviving uncorrected TOF patients documented in the Indian population.