Left ventricular dysfunction and massive intracavitary thrombus in unrepaired tetralogy of Fallot with endomyocardial fibroelastosis: a case report

Abstract Left ventricular dysfunction and thrombosis in unrepaired tetralogy of Fallot are rarely reported. We report the case of a 9-year-old boy with unrepaired tetralogy of Fallot, severe biventricular dysfunction, large left ventricular thrombus, and diffuse subendocardial fibroelastosis. After surgical repair, recovery of ventricular function and thrombus resolution were observed. This case highlights the interplay between cyanosis, myocardial remodelling, and hypercoagulability and emphasises the role of multimodality imaging.