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Tetralogy of Fallot with double aortic arch

  • Andrew Robert Harper (a1), Monica Dai (a2) and Rashmi M. Prabhatha (a3)

An 8 year old girl presents with cyanosis, exertional dyspnoea, and palpitation only. X-ray displayed a typical coeur en sabot heart and auscultsation revealed a harsh ejection systolic murmur. Echocardiography confirmed Tetralogy of Fallot (McGoon ratio 1.3) and computed tomography was requested for further investigation of pulmonary stenosis. A vascular ring was detected, presenting asymptomatically and previously missed through echocardiography. The patient underwent a double-stage repair with ligation of an aortic arch. Recovery was unremarkable. This case highlights the limitations of echocardiography in detection of extra-cardiac anomalies.

Corresponding author
Correspondence to: A. R. Harper, Institute of Genetic Medicine, Newcastle University, Institute of Medical Sciences, Newcastle Upon Tyne, NE1 3BZ, United Kingdom. E-mail:
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Cardiology in the Young
  • ISSN: 1047-9511
  • EISSN: 1467-1107
  • URL: /core/journals/cardiology-in-the-young
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