Angela I Odike1
,
Agwemuria M Obakore1,
Maxy A Odike2,
Efosa Isibor1
For correspondence:- Angela Odike Email: angelaodike@gmail.com Tel: +2348034096590
Published: 04 September 2021
Citation: Odike AI, Obakore AM, Odike MA, Isibor E. A report of two cases of polycythemia in patients with Tetralogy of Fallot (TOF) in heart failure and the dilemma of management in a resource poor setting. Trop J Med Dent Pract 2021; 2(3):77-81 doi: 10.47227/tjmdp.v2i3.5
© 2021 The author(s).
This is an Open Access article that uses a funding model which does not charge readers or their institutions for access and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0) and the Budapest Open Access Initiative (http://www.budapestopenaccessinitiative.org/read), which permit unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited..
Congenital heart diseases are commonly seen in resource poor settings, like in Sub-Saharan Africa. Tetralogy of Fallot (TOF) is one of the cyanotic congenital heart diseases, and is a known cause of polycythemia. Congestive heart failure, however, is an unusual finding in TOF. The recommended management of polycythemia is treatment of underlying cause (in this case, surgical repair of TOF) or partial exchange blood transfusion (PEBT) when surgery is delayed. The former option is usually not possible in our setting due to poverty. Two cases of TOF with polycythemia and heart failure were seen in our clinic, from ages 3 and 7 years. They were managed conservatively with PEBT and anti-failure regimen because of lack of funds for corrective repair overseas. They survived on this therapy for 14 years and 6 months respectively. This paper aims to draw attention to the challenges encountered, and hence a call for caution, in managing polycythemia in patients with TOF in heart failure using PEBT, with special focus on the immediate or short-term post procedure outcome.
