Hyderabad: Prakesh, 22, hailing from Bihar, was brought to Kamineni Hospitals in the city with a complaint of shortness of breath. Following tests and clinical examination, doctors came to the conclusion that the patient was suffering from Tetralogy of Fallot with Eisenmenger syndrome and severe polycythemia (Hb 22gm/dl) due to low oxygen levels.

Tetralogy of Fallot (TOF) represents approximately 7-10% of all congenital heart diseases (CHDs), and is the most common cyanotic CHD, with 0.23-0.63 cases per 1,000 births. This disorder accounts for a third of all CHD in patients younger than 15 years of age; in adults, TOF has an estimated prevalence of 1 in 3,500 to 1 in 4,300 people.

Speaking on the medical condition, Dr. Mohd Vaseem, Consultant Pulmonologist (Chest Physician) & Sleep Specialist, King Koti, Hyderabad, said, “On examination, we found the patient have clubbing and murmur on Cardiac auscultation that led us to conduct a further examination. On further evaluation, we came to the conclusion that the patient was suffering from Tetralogy of Fallot with Eisenmenger syndrome, which had gone undiagnosed as the patient hailed from a remote village, clearly indicating the lack of medical facilities in such areas.”

“These cases can be managed by complex cardiac surgeries in the early stage. In late stages, such as in the case of Prakesh, treatment is mainly oxygen supplementation, drugs to lower Pulmonary Arterial Hypertension, hydroxyurea, and venesection to lower the Hb, since high Hb conc is lethal and leads to DVT, PTE, and stroke. The patient recovered due to the treatment and was discharged after five days of observation,” Dr Mohd Vaseem concluded.

Dr. Mohd Vaseem, Senior Pulmonologist, Chest Physician & Sleep Specialist, Dr. Mirza Mohammed Baig, Clinical Cardiologist & Dr. M. A. Muqsith Quadri, Senior General Physician & Diabetologist, and the nursing team participated in the surgery and treatment.

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