Tet spell in an adult

Area of Science:

• Cardiology
• Pediatric Cardiology
• Emergency Medicine

Background:

• Central cyanosis, a bluish skin discoloration, typically arises from cardiovascular or pulmonary shunts.
• Tet spells, characterized by episodic cyanosis, are usually linked to congenital heart disease like Tetralogy of Fallot (TOF).
• Adults with untreated TOF are rare, making tet spells in this demographic an infrequent emergency department presentation.

Observation:

• A 29-year-old male presented with a cyanotic spell.
• The patient was diagnosed with Tetralogy of Fallot (TOF) after the event.
• This case underscores the potential for TOF to manifest in adulthood.

Findings:

• Tetralogy of Fallot (TOF) can present with hypercyanotic crises in adults.
• Adult-onset tet spells are uncommon but critical to identify.
• Prompt diagnosis and management of TOF in adults are crucial.

Implications:

• TOF should be considered in the differential diagnosis of hypercyanotic crises in adult patients.
• Early recognition and appropriate management of adult TOF can avert significant morbidity and mortality.
• This case emphasizes the need for awareness of TOF's unique adult manifestations and treatment strategies.