The tetralogy of Fallot

Two cases are presented, in which, at autopsy, there were changes in the heart which compose the tetralogy of Fallot, namely, right ventricular hypertrophy, pulmonic stenosis, interventricular septal defect, and dextroposition of the aorta. The patients were 53 and 43 years of age, respectively. The first, it is believed, orginally had an Eisenmenger variant, with no pulmonic stenosis. Rheumatic pulmonic valvulitis, acquired late in life, resulted in pulmonic stenosis, completing the tetralogy and contributing greatly to his disability and death. The second patient had the true tetralogy from birth. The presence of patency of the ductus arteriosus, and, later, of systemic hypertension, may have helped alleviate the cardiodynamic derangement and contributed to her longevity.