Tetralogy of Fallot

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Tetralogy of Fallot
Synonyms	TOF
Pronounce	N/A
Specialty	N/A
Symptoms	Cyanosis, difficulty in feeding, failure to thrive, heart murmur
Complications	Infective endocarditis, heart failure, stroke
Onset	Birth
Duration	Lifelong
Types	N/A
Causes	Congenital heart defect
Risks	Rubella, alcohol use during pregnancy, diabetes, older maternal age
Diagnosis	Echocardiogram, chest X-ray, electrocardiogram
Differential diagnosis	Ventricular septal defect, pulmonary stenosis, transposition of the great arteries
Prevention	N/A
Treatment	Surgery, medication
Medication	Prostaglandin E1, beta blockers
Prognosis	Generally good with treatment
Frequency	1 in 2,000 newborns
Deaths	Rare with treatment

Pronunciation

Tetralogy of Fallot is pronounced te-tral-uh-jee of Fal-oh.

What is Tetralogy of Fallot?

Tatrology of Fallot is a birth defect that affects normal blood flow through the heart. A tetralogy simply means four things and the Tetrology of Fallot involves the following four defects:

• A ventricular septal defect
• Pulmonary stenosis
• The aortic valve connects to both ventricles as opposed to only the left, and it sits directly on top of the ventricular septal defect.
• The muscular wall of the lower right ventricle is thicker than normal called ventricular hypertrophy.

Heart tetralogy Fallot

Critical congenital heart defect

Because a baby with tetralogy of Fallot may need surgery or other procedures soon after birth, this birth defect is considered a critical congenital heart defect.

Symptoms

This heart defect leads to cyanosis. Infants with tetralogy of Fallot can have a bluish-looking skin color―called cyanosis―because their blood doesn’t carry enough oxygen. At birth, infants might not have blue-looking skin, but later might develop sudden episodes of bluish skin during crying or feeding. These episodes are called tet spells.

• Infants with tetralogy of Fallot or other conditions causing cyanosis can have problems including:
• A higher risk of getting an infection of the layers of the heart, called endocarditis.
• A higher risk of having irregular heart rhythms, called arrhythmia.
• Dizziness, fainting, or seizures, because of the low oxygen levels in their blood.
• Delayed growth and development.

Diagnosis

Tetralogy of Fallot may be diagnosed during pregnancy or soon after a baby is born.

During Pregnancy

A fetal echocardiogram is an ultrasound of the heart of the fetus which show problems with the structure of the heart and how the heart is working with this defect.

After a Baby Is Born

• Tetralogy of Fallot usually is diagnosed after a baby is born, often after the infant has an episode of turning blue during crying or feeding (a tet spell).
• Some findings on a physical exam may make the health care provider think a baby may have tetralogy of Fallot, including bluish-looking skin (cyanosis) or a heart murmur.
• The most common test is an echocardiogram.
• Pulse oximetry is a simple bedside test to estimate the amount of oxygen in a baby‚Äôs blood.
• Low levels of oxygen in the blood can be a sign of a critical CHD.
• Newborn screening using pulse oximetry can identify some infants with a critical CHD, like tetralogy of Fallot, before they show any symptoms.

Treatments

• Tetralogy of Fallot can be treated by surgery soon after the baby is born.
• During surgery, doctors widen or replace the pulmonary valve and enlarge the passage to the pulmonary artery.
• They also will place a patch over the ventricular septal defect to close the hole between the two lower chambers of the heart.
• These actions will improve blood flow to the lungs and the rest of the body.

Prognosis

• Most infants will live active, healthy lives after surgery. However, they will need regular follow-up visits with a cardiologist.
• As adults, they may need more surgery or medical care for other possible problems.

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