title: Tetralogy of Fallot with rheumatic mitral stenosis: a case report.
abstract: BACKGROUND
  Rheumatic and congenital heart diseases account for the majority of hospital admissions for cardiac patients in India. Tetralogy of Fallot is the most common congenital heart disease with survival to adulthood. Infective endocarditis accounts for 4% of admissions to a specialized unit for adult patients with a congenital heart lesion. This report is unique in that a severe stenotic lesion of the mitral valve, probably of rheumatic aetiology, was noted in an adult male with Tetralogy of Fallot.
  
  
  METHODS
  An unusual association of rheumatic mitral stenosis in an adult Indian male patient aged 35 years with Tetralogy of Fallot and subacute bacterial endocarditis of the aortic valve is presented.
  
  
  CONCLUSIONS
  In this case report the diagnostic implications, hemodynamic and therapeutic consequences of mitral stenosis in Tetralogy of Fallot are discussed. In addition, the morbidity and mortality of infective endocarditis in adult patients with congenital heart disease are summarized. The risk of a coincident rheumatic process in patients with congenital heart disease is highlighted and the need for careful attention to this possibility during primary and follow-up evaluation of such patients emphasized.
authors.affiliation: Department of Cardio-Thoracic Surgery, Apollo Heart Institute, Visakhapatnam, Andhra Pradesh, India. csaikrishna@yahoo.com
authors.forename: Cheemalapati
authors.initials: C
authors.lastname: Sai Krishna
authors.forename: Gangireddy Venkateswara
authors.initials: GV
authors.lastname: Reddy
authors.forename: Mohan
authors.initials: M
authors.lastname: Debta
authors.forename: Nanda Kishore
authors.initials: NK
authors.lastname: Panigrahi