What is Tetralogy of Fallot: Exploring Complex Heart Condition’s Causes, Symptoms, and Treatment

Heart surgeries have improved a lot over the years. Thanks to advances in medicine, many children born with heart issues can now live healthy lives. Among these complex conditions is Tetralogy of Fallot (TOF), a heart defect present from birth. It may sound scary, but understanding it can help families manage and treat it effectively. Dr Prashant Bobhate, Consultant at the Children’s Heart Centre, Kokilaben Dhirubhai Ambani Hospital in Mumbai, explains what TOF is and how kids with this condition can get better with timely care.

What is Tetralogy of Fallot?

Dr Bobhate describes Tetralogy of Fallot as a congenital heart defect, which means the baby is born with it. It affects about 1 in every 2,000 babies. This condition affects how blood moves from the heart to the lungs and the rest of the body. TOF includes four heart problems happening together:

• Ventricular Septal Defect (VSD): A hole between the lower chambers of the heart lets blood flow abnormally.
• Pulmonary Stenosis: The blood vessel leading to the lungs is narrower than normal, making it hard for blood to flow there.
• Overriding Aorta: The aorta shifts position and receives blood from both sides of the heart, mixing oxygen-rich and oxygen-poor blood.
• Right Ventricular Hypertrophy: The right lower chamber of the heart thickens because it has to work harder to pump blood.

“These defects reduce the oxygen level in the blood,” says Dr. Bobhate. “That’s why babies with TOF often look bluish, especially during crying or feeding, because less oxygen reaches their bodies.” This blue tint is called cyanosis.

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Signs and Symptoms to Watch For Tetralogy of Fallot

Early diagnosis of the symptoms of TOF makes it easy to treat it easily. Some of the common symptoms are:

• Bluish lips or skin, particularly at the corners of the mouth and the fingertips
• Rapid breathing when being fed or in a moving state
• Fatigues or weakens easily during the process of feeding or playing
• In case your baby exhibits such symptoms, you need to consult a doctor as soon as possible.
• Sudden episodes of deep blue skin with breathlessness, called “tet spells”

How is Tetralogy of Fallot Diagnosed?

Early diagnosis may help a great deal. Dr. Bobhate explains:

• Fetal Echocardiography: The procedure is conducted at 18-24 weeks of pregnancy, and it is used to identify TOF before birth. The early diagnosis will enable the doctors to ensure safe delivery and care.
• 2D Echocardiogram: It is an ultrasound scan that is used to confirm the diagnosis after birth; it is also used to guide physicians in making the most effective treatment decisions.
• CT Pulmonary Angiogram: In rare cases, a CT Pulmonary Angiogram is utilised to get a better idea of the heart and circulatory system.
• Pulse Oximeter Monitoring: This miniature machine can be used by the parents at home to monitor the amount of oxygen in the baby and notice any deteriorating condition as early as possible.

Treatment Options for Tetralogy of Fallot

Treatment depends on how severe the condition is. Dr Bobhate says:

• Temporary Stabilisation: In some cases, a baby can be supported with a PDA (patent ductus arteriosus) or RVOT (right ventricular outflow tract) stent or a Blalock-Taussig (BT) shunt, and its association will help to get more blood to flow to the lungs prior to complete surgery.
• Corrective Surgery: It is carried out at age 6-12 months. The surgeon patches up the hole, enlarges the narrow vessel, and straightens the rest of the issues to allow the blood to move normally. The surgery increases the oxygen and enhances the health of the baby.
• Pulmonary Valve Replacement: In later childhood or adulthood, other patients need the replacement of the pulmonary valve to maintain the functionality of the heart.

Follow-ups with a congenital heart specialist on a lifetime basis, even after surgery, are important. When asked to wrap things up, Dr Bobhate shares, “The best thing to do is to monitor on a regular basis to detect any alteration in heart functioning or complications at an early stage.” Most cases successfully managed can live and move around healthily, like other normal children, with proper management.

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Final Thoughts

Tetralogy of Fallot may sound complicated, but modern medicine offers great hope. Early diagnosis, the right surgery, and continuous care can help most children live full, happy lives. Awareness of symptoms and following expert advice is the first step toward managing this condition successfully.