Right-sided weakness in a Rwandan patient with untreated Tetralogy of Fallot
Abstract Background Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease encountered in pediatrics with surgical repair being the definitive treatment. Long-term survival after surgical repair has improved; however, reported mortality rates in untreated TOF are significant....
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | International Journal of Emergency Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12245-023-00494-0 |
| _version_ | 1797865669832736768 |
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| author | Sylvain Tshilombo Romeo Bilugan Amanda Feeney Jonathan Im Heather M. Kuntz Kavita Gandhi Besh Barcega Jean Felix Babane Vincent Ndebwanimana Mindi Guptill |
| author_facet | Sylvain Tshilombo Romeo Bilugan Amanda Feeney Jonathan Im Heather M. Kuntz Kavita Gandhi Besh Barcega Jean Felix Babane Vincent Ndebwanimana Mindi Guptill |
| author_sort | Sylvain Tshilombo |
| collection | DOAJ |
| description | Abstract Background Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease encountered in pediatrics with surgical repair being the definitive treatment. Long-term survival after surgical repair has improved; however, reported mortality rates in untreated TOF are significant. Associated complications include neurological sequelae such as brain abscess and stroke. In countries without early intervention for congenital heart disease (including TOF), delayed presentations and complications require recognition by healthcare workers. Case presentation A 22-year-old male with a history of untreated TOF presented to Rwanda’s tertiary university hospital, University Teaching Hospital of Kigali, with acute right-sided hemiparesis. Diagnostic imaging identified a left-sided brain lesion consistent with brain abscess and cardiac mass, concerning endocardial vegetation. He was managed with intravenous antibiotics but subsequently died due to complications of septicemia. Discussion In countries where surgical repair of TOF is not available, early recognition and medical management are key in temporizing the development of devastating sequelae. Describing the prevalence of CHD in Rwanda is urgent, requiring further research by which effective prevention and treatment strategies can be developed. |
| first_indexed | 2024-04-09T23:11:53Z |
| format | Article |
| id | doaj.art-58035ebb4b9d4f639a25ec98f0f4ff51 |
| institution | Directory Open Access Journal |
| issn | 1865-1380 |
| language | English |
| last_indexed | 2024-04-09T23:11:53Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Emergency Medicine |
| spelling | doaj.art-58035ebb4b9d4f639a25ec98f0f4ff512023-03-22T10:20:25ZengBMCInternational Journal of Emergency Medicine1865-13802023-03-011611410.1186/s12245-023-00494-0Right-sided weakness in a Rwandan patient with untreated Tetralogy of FallotSylvain Tshilombo0Romeo Bilugan1Amanda Feeney2Jonathan Im3Heather M. Kuntz4Kavita Gandhi5Besh Barcega6Jean Felix Babane7Vincent Ndebwanimana8Mindi Guptill9Department of Anesthesia, Emergency Medicine and Critical Care, University of RwandaDepartment of Emergency Medicine, Loma Linda University School of MedicineDepartment of Emergency Medicine, Loma Linda University School of MedicineDepartment of Emergency Medicine, Loma Linda University School of MedicineDepartment of Emergency Medicine, Loma Linda University School of MedicineDepartment of Emergency Medicine, University of CaliforniaDepartment of Emergency Medicine, Loma Linda University School of MedicineDepartment of Emergency Medicine, University Teaching Hospital of KigaliDepartment of Emergency Medicine, University Teaching Hospital of KigaliDepartment of Emergency Medicine, Loma Linda University School of MedicineAbstract Background Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease encountered in pediatrics with surgical repair being the definitive treatment. Long-term survival after surgical repair has improved; however, reported mortality rates in untreated TOF are significant. Associated complications include neurological sequelae such as brain abscess and stroke. In countries without early intervention for congenital heart disease (including TOF), delayed presentations and complications require recognition by healthcare workers. Case presentation A 22-year-old male with a history of untreated TOF presented to Rwanda’s tertiary university hospital, University Teaching Hospital of Kigali, with acute right-sided hemiparesis. Diagnostic imaging identified a left-sided brain lesion consistent with brain abscess and cardiac mass, concerning endocardial vegetation. He was managed with intravenous antibiotics but subsequently died due to complications of septicemia. Discussion In countries where surgical repair of TOF is not available, early recognition and medical management are key in temporizing the development of devastating sequelae. Describing the prevalence of CHD in Rwanda is urgent, requiring further research by which effective prevention and treatment strategies can be developed.https://doi.org/10.1186/s12245-023-00494-0Tetralogy of FallotPediatricsCongenital heart diseaseRwanda |
| spellingShingle | Sylvain Tshilombo Romeo Bilugan Amanda Feeney Jonathan Im Heather M. Kuntz Kavita Gandhi Besh Barcega Jean Felix Babane Vincent Ndebwanimana Mindi Guptill Right-sided weakness in a Rwandan patient with untreated Tetralogy of Fallot International Journal of Emergency Medicine Tetralogy of Fallot Pediatrics Congenital heart disease Rwanda |
| title | Right-sided weakness in a Rwandan patient with untreated Tetralogy of Fallot |
| title_full | Right-sided weakness in a Rwandan patient with untreated Tetralogy of Fallot |
| title_fullStr | Right-sided weakness in a Rwandan patient with untreated Tetralogy of Fallot |
| title_full_unstemmed | Right-sided weakness in a Rwandan patient with untreated Tetralogy of Fallot |
| title_short | Right-sided weakness in a Rwandan patient with untreated Tetralogy of Fallot |
| title_sort | right sided weakness in a rwandan patient with untreated tetralogy of fallot |
| topic | Tetralogy of Fallot Pediatrics Congenital heart disease Rwanda |
| url | https://doi.org/10.1186/s12245-023-00494-0 |
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