Abstract
Tetralogy of fallot (TOF) is the most common form of cyanotic congenital heart disease. Unlike in the western world where adult TOF is a rarity, in the developing countries without cardiac surgical centers and inadequate medical treatment, patients die early, so adult untreated TOF is worth reporting. A 23 year old man presented with chest pains of 18 months, exertional dyspnea, palpitations and a history of squatting since childhood. Examination revealed central cyanosis, Grade 4 digital clubbing, with pansystolic and ejection systolic murmurs over tricuspid and pulmonary areas. However, chest radiograph, electrocardiogram (ECG) and echocardiograms confirmed the tetralogy of fallot. Key words: Adult, tetralogy of fallot, untreated, Nigerian.
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