Tetralogy of Fallot (ToF) is a cyanotic inborn heart abnormality that is diagnosed by four main anomalies which includes pulmonary stenosis, ventricular septal defect, overriding of aorta and right ventricular hypertrophy. ToF is frequently observed in newborns and should be screened for ToF, if there are any classical signs and symptoms are observed.

In the present case study, there is a  19 years old female patient hospitalized with  a chief complaints of chest pain and was been diagnosed with ToF  finally based on the  investigations such as ECG, Echocardiogram and some other clinical significances. The clinical management was done by necessary pharmacotherapy which improved the patient condition better. The patients had a same clinical signs and symptoms in her childhood and was not been screened for ToF, if she would have been diagnosed at early age and necessary pharmacotherapy/surgical intervention were made, the patient would not have suffered at early teenage.  Hence it is an alarm for all the physicians and other healthcare professionals to screen the patients for ToF in the early age group and induction of necessary pharmacotherapy/surgical intervention in order to minimize morbidity and mortality rate in early childhood/teenage.