Abstract
Repair of Tetralogy of Fallot (TOF) has significantly improved long-term mortality. A consequence of repair is pulmonic valve insufficiency, leading to cardiac remodeling in adulthood, which can often remain asymptomatic for an extended period. This emphasizes the importance of consistent follow-up with an adult congenital heart disease physician to evaluate for these pathophysiologic consequences. We present a case of a young female patient with a history of TOF status post-repair who was lost to follow-up.