Tetralogy of fallot history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Priyamvada Singh, M.B.B.S. [2], Keri Shafer, M.D. [3]; Assistant Editor-In-Chief: Kristin Feeney, B.S. [4]

Overview

Tetralogy of Fallot causes cyanosis, dyspnea, failure to thrive and potentially fatal tet spells.

History and Symptoms

• Right ventricular outflow obstruction determines the clinical presentation
• The primary symptom is low blood oxygen saturation with or without cyanosis from birth or developing in the first year of life. In the absence of cyanosis, the baby is referred to as a "pink tet".
• Cyanosis becomes progressively worse with time as the patient outgrows the ability of pulmonary blood flow to keep up with increasing oxygen demands.
• The following factors exacerbate cyanosis and should be avoided if at all possible:

• Acidosis
• Stress
• Infection
• Posture (upright, not squatting)
• Exercise
• Beta-adrenergic agonists
• Dehydration
• Closure of the patent ductus arteriosus

• Tet spells characterized by a sudden, marked increase in cyanosis, syncope, which may result in hypoxic brain injury and death.
• Difficulty in feeding
• Failure to gain weight
• Failure to thrive
• Retarded growth and physical development
• Dyspnea on exertion
• Hempotysis

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