A 4-year-old boy had a history of intellectual disability and seizure is brought to doctor with a month of history of shoness of breath. On physical examination, doctor notices numerous papule on boy face. Echocardiography shows tumor like growth in left ventricle. Which of the following is the most likely diagnosis for this patient hea condition?

**Core Concept**
The patient's presentation, including intellectual disability, seizures, shortness of breath, and a tumor-like growth in the left ventricle, suggests a cardiac condition associated with extracardiac abnormalities. This condition is a classic example of a congenital heart defect with a specific genetic or chromosomal etiology.

**Why the Correct Answer is Right**
The patient's symptoms and physical examination findings are highly suggestive of Rhabdomyoma, a benign tumor of the heart muscle. Rhabdomyomas are typically associated with Tuberous Sclerosis Complex (TSC), a genetic disorder that also affects the brain, leading to intellectual disability and seizures. The tumor-like growth in the left ventricle seen on echocardiography is consistent with a rhabdomyoma. TSC is caused by mutations in either the TSC1 or TSC2 gene, which regulate the mTOR pathway.

**Why Each Wrong Option is Incorrect**
* **Option A:** Hypertrophic Cardiomyopathy is a genetic disorder characterized by thickening of the heart muscle, but it does not typically present with intellectual disability, seizures, or the characteristic skin lesions (papules) seen in this patient.
* **Option B:** Cardiomyopathy associated with Duchenne Muscular Dystrophy (DMD) typically presents with progressive muscle weakness and cardiac dysfunction, but it does not typically involve intellectual disability, seizures, or rhabdomyomas.
* **Option C:** Tetralogy of Fallot is a congenital heart defect characterized by four specific heart defects, but it does not typically involve intellectual disability, seizures, or rhabdomyomas.

**Clinical Pearl / High-Yield Fact**
Rhabdomyomas are the most common cardiac tumors in children, and they are almost always associated with Tuberous Sclerosis Complex (TSC). The presence of a rhabdomyoma in a child should prompt a thorough evaluation for TSC, including imaging of the brain and skin examination for ash-leaf spots and other characteristic lesions.

**Correct Answer:** C.

✓ Correct Answer: C. Rhabdomyoma