An unusual congenital heart disease, Pentalogy of Fallot

Abstract

Introduction: Fallot's pentalogy is a cyanotic congenital heart disease, with right-to-left shunt and decreased pulmonary flow, which appears when adding a fifth cardiac anomaly to Fallot's tetralogy: atrial septal defect. 
Objectives: The objective was to expose as clearly as possible the order of the clinical method applied during medical practice, the symptoms and signs that allowed diagnosing this entity and redirecting behavior.
 Case presentation: We present the case of a 43-year-old patient, who from birth presented crises of respiratory distress, moderate mental retardation and musculoskeletal development; she was diagnosed with Tetralogy of Fallot and was considered by the surgical team as inoperable. She went to the clinic for a progressive worsening of her condition, physical examination detected acrocyanosis, Hippocratic fingers and holosystolic murmur of intensity IV-V/VI on the left sternal border. A series of imaging and electrocardiographic examinations were performed to establish the diagnosis, which included plain chest X-ray in posteroanterior projection and echocardiogram, the latter allowing the definitive diagnosis; Pentalogy of Fallot. The recommended treatment for this condition is heart surgery. 
Conclusions: Congenital heart disease has a diverse presentation around the world, as well as its severity. It was decided to present the case because it was uncommon in medical practice due to its low frequency. This made clear the relevance of an early diagnosis of these entities for the patient's quality of life.