AN AMERICAN CASE REPORT OF APPARENT TETRALOGY OF FALLOT PUBLISHED ALMOST FIFTY YEARS PRIOR TO FALLOT'S CLASSIC REPORT IN 1888

Abstract

In 1888 Etienne L. A. Fallot (1850-1911) gave an important but not the first account of the condition that bears his name.1 The earliest American description of a child with putative tetralogy of Fallot that I have been able to find was reported in 1842 as follows: About two years since, I was called to visit a child of Mr. S., of this town, aged two years and six months. Mrs. S. related the history of the case as follows. From birth to the age of eleven months, there was nothing unnatural in the health or appearance of the child. At this time it began to be very much afflicted by ill turns, attended with laborious respiration, palpitation and a peculiar blueness of the skin. After a few minutes the paroxysm would pass off, leaving her in a state of great exhaustion. These paroxysms continued, at regular intervals, with increasing severity, up to the time of its death, which occurred on the 14th inst. Post-mortem Examination, Sixteen Hours after Death.—Body very much emaciated; face bloated; skin blue; lungs small and dark colored; one and a half ounces of serum in pericardium; heart weighed five and a half ounces; hypertrophy of right ventricle; aorta communicated with both ventricles equally; pulmonary artery very small; its communication with the right ventricle would barely admit a common blunt-pointed probe; foramen ovate imperfectly closed. The remaining viscera natural, with the exception of color, which might be expected from the imperfect arterialization of the blood (A. C. Smith, MD, Haverhill [MA], July 22, 1842).