9th May 2025

A 25-year-old female presents to her routine cardiology follow up appointment, due to previously corrected underlying congenital heart defect.

A 25-year-old female presents to her routine cardiology follow up appointment, due to previously corrected underlying congenital heart defect. 

She currently reports no shortness of breath, exertional dyspnoea or ankle swelling. Her only other past medical history is asthma for which she takes salbutamol inhaler QDS PRN. She currently works part time as a receptionist in a GP practice.

On examination she has a visible midline sternotomy scar. Her lung bases are clear, with good air entry throughout. There is audible midsystolic high-pitched crescendo-decrescendo murmur heard loudest at the left upper sternal edge. She is scheduled for a repeat echocardiogram to assess the status of her previously repaired pulmonary valve, as part of her Tetralogy of Fallot condition.

Which of the following is not a feature of Tetralogy of Fallot?

Select the SINGLE most appropriate option from the list below. Select ONE option only.