title: Tet spell in an adult.
abstract: Cyanosis is a bluish skin due to deoxygenated hemoglobin or methomoglobin in the arterial blood.Central cyanosis mostly results from cardiovascular or pulmonary shunts. Tet spell is an episodic central cyanosis due to total occlusion of right ventricle outflow in a patient with a congenital heart disease, such as Tetralogy of Fallot (TOF). There are limited cases of patients who lived with untreated TOF until adulthood. Tet spell in an adult is rarely seen in an emergency department. Early recognition of this condition, along with proper disposition andmanagement, can prevent majormorbidity or mortality. We report a 29-year-old man who presented with cyanotic spell and in whom a diagnosis of TOF was later confirmed. This case reminds us of TOF as a differential diagnosis of hypercyanotic crises and its unique manifestations and management.
authors.affiliation: Department of Emergency Medicine, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Tao-Yuan, Taiwan.
authors.forename: Yi-Ming
authors.initials: YM
authors.lastname: Weng
authors.affiliation: Department of Emergency Medicine, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Tao-Yuan, Taiwan. Electronic address: changyuche@adm.cgmh.org.tw.
authors.forename: Yu-Che
authors.initials: YC
authors.lastname: Chang
authors.affiliation: Department of Emergency Medicine, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Tao-Yuan, Taiwan.
authors.forename: Te-Fa
authors.initials: TF
authors.lastname: Chiu
authors.affiliation: Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan.
authors.forename: Chia-Sui
authors.initials: CS
authors.lastname: Weng
mesh_terms: D000328:Adult; D003490:Cyanosis / Q000209:etiology*; D004417:Dyspnea / Q000209:etiology*; D006801:Humans; D008297:Male; D013771:Tetralogy of Fallot / Q000150:complications / Q000175:diagnosis*