Thirty-Two-Year-Old Woman With Corrected Tetralogy of Fallot

A 32-year-old, asymptomatic woman with history of tetralogy of Fallot (TOF) presented for evaluation of her congenital heart disease. Surgical history consisted of a Blalock-Taussig shunt in early childhood and subsequent TOF repair at age 3 years. On examination, venous pressure was visualized 4 cm above the clavicle at 45° with a prominent a wave. A parasternal lift was present. Auscultatory findings at the left upper sternal border are provided in the corresponding Audio. An electrocardiogram (Figure 1A) revealed sinus rhythm with a right bundle branch block. Findings from a transthoracic echocardiogram (TTE) are shown in Figure 1B and Video 1. Right ventricular diastolic volume index, quantitated by cardiac magnetic resonance, was 161 mL/m².