Tetralogy of fallot

Tetralogy of Fallot
Synonyms	Fallot’s syndrome, Fallot’s tetrad, Steno-Fallot tetralogy
Diagram of a healthy heart and one with tetralogy of Fallot
Classification and external resources
Specialty	Cardiac surgery, pediatrics
ICD-10	Q21.3
ICD-9-CM	745.2
OMIM	187500
DiseasesDB	4660
MedlinePlus	001567
eMedicine	emerg/575
Patient UK	Tetralogy of Fallot
MeSH	D013771
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Tetralogy of Fallot (TOF) is a congenital heart defect that is present at birth. Symptoms include episodes of bluish color to the skin. When affected babies cry or have a bowel movement, they may develop a "tet spell" where they turn very blue, have difficulty breathing, become limp, and occasionally lose consciousness. Other symptoms may include a heart murmur, finger clubbing, and easy tiring upon breastfeeding.

The cause is typically not known. Risk factors include a mother who uses alcohol, has diabetes, is over the age of 40, or gets rubella during pregnancy. It may also be associated with Down syndrome. Classically there are four defects:

TOF is typically treated by open heart surgery in the first year of life. Timing of surgery depends on the baby's symptoms and size. The procedure involves increasing the size of the pulmonary valve and pulmonary arteries and repairing the ventricular septal defect. In babies who are too small a temporary surgery may be done with plans for a second surgery when the baby is bigger. Most people who are affected live to be adults. Long-term problems may include an irregular heart rate and pulmonary regurgitation.

TOF occurs in about 1 in 2,000 newborns. Males and females are affected equally. It is the most common complex congenital heart defect. It was initially described in 1671 by Niels Stensen. A further description occurred in 1888 by the French physician Étienne-Louis Arthur Fallot, after whom it is named. The first surgical repair was carried out in 1954.

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