Tetralogy of Fallot

Tetralogy of Fallot! This is a cyanotic congenital heart disease that is consisting of four features which are:
1. Pulmonary Stenosis or atresia

2. Dextroposition of the aorta

3. Ventricular Septal defect 

4. Right Ventricular hypertrophy

Like most of the congenital heart diseases, the actual cause of the arrested cardiac development in this syndrome is unknown. 

However, there are reports associating it with german measles infection and with prematurity.

Clinically, patients suffering from this Tetralogy of Fallot will have cyanosis (bluish discoloration) and its onset is related to the severity of the stenosis. 

This is usually present at 3-6 months of age or when the child already becomes active. The cyanosis may appear by exercise, straining and crying. 

Some patients may have the following:

  • clubbing of the fingers and toes
  • retarded growth and development
  • dyspnea on exertion
  • exercising intolerance

The hypoxia or cyanotic spells are characterized by the following:

  • Dyspnea ( difficulty in breathing)
  • Increasing cyanosis
  • Syncope
  • Sometimes convulsions

Patients with tetralogy of Fallot should be closely monitored by cardiologists to prevent serious complications. 

The basic cause of death is anoxia in 3/4 of the cases. Other complications include:

  1. Cerebral abscess in 1/4 of cases beyond the age of 2
  2. Cerebral vein thrombosis
  3. Cerebral embolism
  4. Congestive heart failure