Tetralogy of Fallot
Abbott1 has classified congenital defects of the cardiovascular system in three principal groups: (1) the a-cyanotic group, (2) the group of cases in which there is an arteriovenous shunt with possible transient cyanosis due to reversal of flow through the defect, and (3) the cyanotic group (morbus caeruleus) in which cyanosis is permanently present.
The tetralogy of Fallot is the most common member of the cyanotic group. The tetrad consists of a defect of the ventricular septum, pulmonary or infundibular stenosis, dextroposition of the aorta, and hypertrophy of the right ventricle. The aorta arises from both ventricles above a large, smooth-walled defect in the upper part of the interventricular septum. Maude Abbott2 found the average duration of life in 83 cases to be 12¾ years. White3 has reported a case in which the patient lived to the age of 59 years and 9 months.
Report of Case
The patient, a 15 year old boy, was admitted to the clinic on December 23, 1937, with the chief complaints of dyspnea on slight exertion, poor appetite, constipation, and abdominal pain. A blue baby at birth, he had always had a poor appetite and had taken a very inadequate diet. Since birth there had been dyspnea on slight exertion and cyanosis had been present constantly. In the 8 months before his admission, there had been several episodes of bleeding from the mouth and into the subcutaneous tissues, and for 2 weeks he had complained of pain in the lower part of the abdomen. . .