A rare case of Tetralogy of Fallot with right atrial thrombus presenting with hemiplegia complicating the clinical course

Background: Cerebrovascular accidents represent a dangerous complication of cyanotic children with tetralogy of Fallot with the incidence of 8.6%. Tetralogy of Fallot has been associated with raised hematocrit with low arterial saturation.

Aim: Here we describe an 18 months old female child of Tetralogy of Fallot with cyanotic spells acute onset right-sided hemiplegia with right atrial thrombus who underwent emergency surgery with the intraoperative predicament.

Materials and methods: A female child with Tetralogy of Fallot presented to emergency department with acute onset right sided hemiplegia. After hemodynamic stabilization the patient underwent series of investigations and was diagnosed to have thrombus of size in right atrium.

Discussion: Among the few causes causing neurological complications in Tetralogy and Fallot, right atrial thrombus appears to be a rare but possible cause.

Conclusion: ntracardiac thrombus can be considered as a cause for embolic neurological events in patients with Tetralogy of Fallot.