Challenges in diagnosing pulmonary embolism in an adult with Fontan physiology: a case report

BACKGROUND: With the increasing longevity of congenital heart disease patients and limited number of adult congenital heart disease specialists, it is becoming increasingly imperative for general cardiologists to understand not only the unique physiology of Fontan patients but also imaging protocol considerations when treating this group of patients. CASE SUMMARY: Here, we present a patient with a history of congenital tricuspid atresia status after the Fontan procedure who presented for gut translocation–related bacteraemia. Importantly, the patient was falsely diagnosed with pulmonary embolism resulting from inaccurate acquisition of computed tomography imaging. DISCUSSION: This case illustrates the complex intricacies that clinicians should consider when facing the challenge of treating Fontan patients.