# Trilogy of Fallot With a Large Right Atrial Thrombus: A Case Report

## TL;DR

A young man with a rare heart condition and a large blood clot in his heart showed improvement after treatment with medication and a procedure to open his pulmonary valve.

## Contribution

This case report highlights the management of a rare congenital heart disease complicated by a large thrombus and neurological symptoms.

## Key findings

- The patient had Trilogy of Fallot with a large right atrial thrombus and a history of transient ischemic attacks.
- Treatment with low molecular weight heparin and balloon pulmonary valvotomy led to significant clinical improvement.

## Abstract

Trilogy of Fallot is a rare congenital heart disease consisting of pulmonary stenosis, right-to-left interatrial shunt, and right ventricular hypertrophy. It can lead to complications such as thrombus formation as a result of chronic hypoxia leading to erythrocytosis and hyperviscosity, and paradoxical embolisms due to the right-to-left interatrial shunt. This report illustrates a case of a young man who presented with cyanosis and right heart failure with a history of recurrent episodes of transient ischemic attacks. He was found to have Trilogy of Fallot with a large right atrial thrombus. He showed significant improvement following treatment with low molecular weight heparin and thereafter undergoing balloon pulmonary valvotomy.