Tetralogy of Fallot

Tetralogy of Fallot: What Is It?

Your heart’s main function is to pump the blood around your body. Your blood is full of oxygen and nutrients that your body requires. When the blood can’t pump properly because the heart isn’t working efficiently, there is a lack of oxygen around the organs and bodily tissues. Some people are born with heart defects and problems, known as congenital heat defects.

One congenital heart defect is Tetralogy of Fallot and is fatal when not treated. It is called Tet or TOF for short. The name was developed from the doctor who found it (Dr. Etienne Fallot) and the four problems linked to it (tetra).

The four problems are:

  • A ventricular septal defect where there is a hole between the left and right ventricles
  • The pulmonary outflow tract is narrow – the connection between the lungs and heart
  • A thickening of the right ventricle
  • An aorta has shifted in orientation and now lays over the top of the ventricular septal defect

The condition leads to cyanosis, where the skin looks blue because of the lack of oxygen circulating around the body. The oxygen means that the skin looks more pink.

TOF is a rare condition, although it is the most common reason for cyanotic congenital heart disease.

The Causes of TOF and Those at Risk

The reason for TOF to develop is not yet known but doctors have found the risks associated with it:

  • Diabetes
  • Poor prenatal diet
  • Maternal alcoholism
  • Mother being over 40-years-old

Those with TOF also have other disorders, including Down syndrome.

The TOF Symptoms

Some of these symptoms will be present at birth and include:

  • Bluer skin
  • Failing to gain weight/problems eating
  • Bone and skin growing around the fingernails/clubbed fingers
  • Passing out
  • Delays or problems with development

Diagnosing TOF

There are times that the condition is spotted before the baby is born. This is usually due to an abnormality in the heart spotted during an ultrasound. Diagnosis is also possible just after birth if there is the detection of a heart murmur during the initial exam, which leads to other tests, or when the skin is blue in color. Most of the time, diagnosis happens during infancy but the symptoms can be minimal if the defect is not severe, which can lead to a delay. At times, parents can notice something strange and the diagnosis is left to the pediatrician.

There are tests that can be used to help with the diagnosis:

  • A chest x-ray to see the abnormalities in the structure
  • An echocardiogram to see any heartbeat disruptions
  • A hear MRI to see the structural problems
  • A pulse oximetry to check the levels of oxygen in the blood
  • A cardiac catheterization

Treatment for TOF

The only treatment available is surgery. This usually happens within the first few months and helps to close the hole between the venticles and makes the pulmonary valve bigger. If doctors are unable to do a permanent repair, Children’s Hospital of Philadelphia states that a temporary repair happens until it is possible to do the permanent one.

Over 90% of children who have the surgery live to be adults and are able to live normal and healthy lives.

When untreated, there are problems with the development and heart rhythm, which can lead to seizures. It is very rare for the condition to remain untreated forever but if it does then children usually die around the age of 20. However, treatment is usually performed as soon as the condition is caught and it is caught early in most cases.

The rest of the patient’s life will be spent seeing a cardiologist after surgery. This checkup will make sure there are not other health problems present and that all medications are safe to use. There is also usually a checkup with the primary physician. There is the risk of other heart problems developing after surgery, which is why this is so important.

The Long-Term Life of TOF Patients

Some patients will need to limit the amount of exercise that they do. This is something you will need to talk to your doctor about. Those who want to be physically active will need to have a plan designed under a doctor’s watch to make sure it is safe.

It is important to take all medication prescribed. Before taking other medication or any supplements, inform your doctor to make sure there will be no adverse side effects or interactions with your current medication.

It is possible to carry out a normal and productive life after TOF treatment. However, you will be under the watchful eye of your doctor to make sure you do not develop any other medical condition.