NEXMIF and Global developmental delay: A frameshift deletion p.(Pro30Argfs*3) in FLT4 was identified in a patient with tetralogy of Fallot (TOF) and her unaffected mother.15FLT4 haploinsufficiency was recently associated with incompletely penetrant nonsyndromic TOF.15–17 A patient with aortic stenosis, valve dysplasia, and developmental delay had a variant p.(Gly501Valfs*4) in NEXMIF, which was X-linked inherited from the mother with mild intellectual disability and epilepsy.