About Tetralogy of Fallot

August 9, 2011 By

Tetralogy of Fallot Congenital Defect, Heart

Tetralogy of fallot is a type of congenital heart defect, meaning that it is present at birth.  It is categorized as a type of defect made up of at least three but sometimes four different abnormalities, all of which affect the heart and its blood vessels.

Tetralogy of Fallot Causes, Incidence, and Risk Factors

Tetralogy of fallot is classified as a cyanotic heart defect, meaning that it causes low levels of oxygen in the blood.  There are four major abnormalities that make up this condition.

  • A narrowing of the artery and valve that lead from the heart to the lungs which lessens the amount of blood passing between them.
  • A hole in the ventricular wall, also referred to as a ventricular septal defect.
  • Right ventricular hypertrophy, which is a thickened muscular wall in the right ventricular chamber.
  • An aorta that has shifted out of its normal place and now rests in the right ventricle instead of only the left.

These four conditions combine to greatly reduce the amount of oxygen throughout the body.  It is a rare condition, occurring in about four hundred out of every one million births across the world.  Despite its rarity it remains the most common type of cyanotic heart defects.

As is the case with most congenital birth defects, the exact causes of tetralogy of fallot are still unknown.  There are, however, several different factors that have been linked to a higher risk of the condition developing.

  • Diabetes during pregnancy, especially diabetes that is managed poorly, can increase the likelihood of birth defects.
  • Alcohol, drug, and cigarette use during pregnancy can greatly raise the chances of developing birth defects.
  • Genetics play a large part in most congenital heart defects, and family history could influence your child’s condition.
  • Some studies have linked rubella infections of expectant mothers to congenital heart defects.
  • Inadequate nutrition throughout a pregnancy can cause the condition as well.
  • Mothers who become pregnant after the age of forty have a much higher chance of giving birth to children who suffer from tetralogy of fallot and other congenital heart defects.

Tetralogy of Fallot Symptoms

A number of different symptoms will accompany tetralogy of fallot, some more noticeable than others.  Some of the most common symptoms include the following.

  • A bluish or purplish skin color known as cyanosis, which becomes even deeper when the baby is upset.
  • Clubbed fingers.
  • Poor ability to feed or bad feeding habits.
  • No weight gain.
  • Unconsciousness.
  • Inadequate development.

Tetralogy of Fallot Diagnosis

Often something as simple as a stethoscope and a trained physician’s ears will uncover a heart murmur, which is the first step towards a diagnosis of tetralogy of fallot.  Further tests will likely be used to uncover the exact nature of your child’s condition.

  • An X-ray can help uncover some of the tell-tale signs of tetralogy of fallot.
  • An echocardiogram uses sound waves to create an image of the heart, showing doctors the structure of the organ as well as the blood flow within it.
  • An MRI is often used to give a detailed view of the heart, but is more commonly used following a surgical procedure to correct the heart.
  • A complete blood count will likely be used to determine the amount of oxygen in the blood.
  • An EKG may also be used to help determine the electrical impulses within the heart and to track its rhythm.

One or more of these procedures may be run on your baby to help confirm a diagnosis of tetralogy of fallot.

Tetralogy of Fallot Treatment

Surgery is currently the only real course of treatment available to correct tetralogy of fallot.

  • The chest cavity will be opened and numerous repairs will take place, with work taking place on valves, septal defects, and the affected arteries.
  • Most surgeries take place while the child is still an infant in order to improve the chances of survival.
  • Multiple surgeries will likely be needed over the course of several months.
  • The first surgery usually occurs well before the latter ones and focuses on improving blood flow to the lungs and closing the septal defects.
  • Latter surgeries will address other issues.
  • In some cases only a single surgery may be needed.

Tetralogy of Fallot Prognosis

If tetralogy of fallot is left uncorrected, the prognosis is very poor.  Most children will rarely make it beyond the age of twenty without corrective surgery.  However, those who receive the needed surgeries will likely enjoy a full recovery.  About ninety percent of surgeries are successful and the patients involved will live well into adulthood and even beyond.  Follow up care will likely include regular checkups to ensure that the heart is working properly and to ensure that leaking of the pulmonary valve doesn’t occur.

Tetralogy of Fallot Complications

When left untreated, tetralogy of fallot will cause numerous serious issues including the following.

  • Irregular heartbeat.
  • Stunted growth and delayed development.
  • Seizures.
  • Periods of unconsciousness.
  • Pulmonary hypertension.
  • Death.

Following corrective surgery, very few complications will present themselves.  The most common may be leaking around the pulmonary valve or arrhythmia.

Contacting Medical Help for Tetralogy of Fallot

Periods of cyanosis should be reason enough to contact your health care provider, and any signs of blue or purple skin need to be dealt with quickly.  Position the child on their back or side and raise its knees upwards while contacting medical help.  You should also contact your physician if any new symptoms present themselves.

After surgery your doctor will provide you with a list of different symptoms that should cause you alarm, and it is vital that you watch for them as well.

Tetralogy of Fallot Prevention

Because it is a form of congenital heart defects there are few things that you can do to prevent the development of tetralogy of fallot.  Avoidance of cigarettes, alcohol, and drugs during pregnancy are the best safeguards that you can take against this condition.  Monitoring diabetes during pregnancy can help as well, and a genetic screening can help determine if you are more likely to have a child who is susceptible to the condition.

Tetralogy of Fallot References

Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine, 8th ed. St. Louis, Mo; WB Saunders; 2007.

http://en.wikipedia.org/wiki/Tetralogy_of_Fallot#Epidemiology

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Filed Under: Tetralogy of Fallot FYI