A rare congenital heart defect (present at birth) that causes four different problems with the heart is called Tetralogy of Fallot. This condition negatively affects the heart structure and causes blood flow changes through the heart and the whole body. Commonly, infants with this condition experience some symptoms, such as gray or blue skin color caused by reduced oxygen levels in the blood. While this condition is usually diagnosed during pregnancy, in some cases, it is identified as soon as after birth. Furthermore, some people with this congenital heart defect may not know about this condition until adulthood because the symptoms are mild or even do not experience any symptoms.
The primary treatment for people with tetralogy of Fallot is surgery and regular checkups during their lifetime.
Symptoms
The symptoms often are different among people because it depends on the amount of blood blocked from leaving the heart and going to the lungs. Check below some symptoms:
- Gray or blue skin color
- Breathing problems (such as shortness of breath, fast breathing, and others)
- Weight gain problems
- Irritability
- Tiredness
- Crying for a long time
- Fainting
What are Tet Spells?
Tet spells happen when the baby suddenly experiences deep gray or blue skin, nails, or lips. They usually occur when the baby cries, eats, or is upset. The main cause of tet spells is a sudden drop in blood oxygen levels. Moreover, these symptoms often happen in infants between 2 and 4 months of age.
Immediately visit a doctor if any of the following symptoms occur. For example:
- Sudden skin, nail, or lip color changes
- Lack of alertness
- Increased irritability
- Weakness
- Seizures
- Severe breathing problems
Causes
Commonly, the exact cause of tetralogy of Fallot is now known but it causes four heart problems. For example:
- Pulmonary valve stenosis – It happens when the valve between the lungs and heart narrows. Therefore, decreased blood flow from the heart to the lungs occurs. Sometimes, pulmonary atresia may happen. A condition in which a solid sheet appears instead of the valve and it blocks blood flow from the heart’s right side.
- Ventricular septal defect – It happens when a hole between the lower chambers of the heart appears. This heart problem causes blood flow changes through the heart and lungs. As a result, the babies may have reduced oxygen levels in the blood making the heart work harder to supply the body with enough oxygen-rich blood.
- Aorta shifting – The main artery in the body is the aorta and it develops in the wrong place.
- Ventricular hypertrophy – This is a heart problem caused by the thickening of the lower chambers of the heart. Over time, it may lead to weakness of the heart muscle and heart failure as well.
Sometimes, people may experience other heart problems such as aorta and heart arteries issues, atrial septal defect (a hole between the upper chambers of the heart), and others.
Risk Factors
While the cause of this congenital heart condition is not known, physicians have identified some factors that may increase the risk of developing it. Examples include:
- Family history of heart disease
- Viral infections during pregnancy (such as German measles also called rubella)
- Alcohol misuse or smoking during pregnancy
- Poor eating during pregnancy
- Pregnant women older than 35 years old
- Babies with Down or DiGeorge syndromes
What Are The Potential Complications of Tetralogy of Fallot?
If this congenital heart defect is left untreated it may cause serious and sometimes life-threatening complications (including disability or even death by early adulthood).
One potential complication of this congenital heart defect is infective endocarditis (infection of the heart or its valves). In some cases, physicians prescribe antibiotics before dental work to prevent this infection in people with tetralogy of Fallot.
However, complications may happen even after surgery to treat this condition. Check below some possible complications:
- Irregular heartbeats
- Abnormal blood flow through a heart valve
- Size changes in the heart chambers
- A hole that does not disappear after surgery
- Sudden cardiac death
- Swelling of the aorta part (also called aortic root dilation)
Thus, additional procedures or surgeries may be needed to treat previous complications.
How to Prevent Tetralogy of Fallot?
It is difficult to discuss ways to prevent this condition because it is not clear what exactly causes it. However, the following tips may help reduce the risk of developing this congenital heart defect. Examples include:
- Proper and regular dental care
- Administer multivitamins with folic acid – It is advised to take roughly 400 milligrams of folic acid per day to reduce the risk of birth defects that negatively affect the brain and spinal cord.
- Quit smoking and choose healthy lifestyle habits (such as regular exercise)
- Get a vaccine for rubella (German measles)
- Manage chronic health conditions (such as diabetes, Phenylketonuria, and others)
- Avoid exposure to chemicals and other harmful substances
- Do not take any medicines without your doctor’s recommendation because it may lead to unpleasant results.
Diagnosis
In most cases, the condition is diagnosed as soon as the baby has skin color changes and it becomes bluish or grayish. However, physicians may perform some tests to confirm the condition and rule out diseases that cause similar symptoms. Check below some of them:
- Oxygen level measurement – This test involves a specific sensor placed under the finger or toe to check the oxygen amounts in the blood. Sometimes, it is called a pulse oximetry test.
- Echocardiogram – This test is used to get images of the heart in motion. It helps doctors understand how well your heart works.
- Electrocardiogram (ECG or EKG) – This is a quick test used to measure the electrical activity of the heart and heartbeats.
- Chest X-ray – This test is used to determine the shape of the heart.
- Cardiac catheterization – This test helps confirm and treat multiple heart conditions. It involves a small and flexible tube inserted in a blood vessel and guided to the heart.
Treatment
Those who have tetralogy of Fallot require surgery to treat the abnormalities of the heart structure and improve blood flow. Check below the most common treatment options used in people with tetralogy of Fallot:
- Temporary repair (temporary surgery) – In some cases, temporary surgery is needed to improve blood flow while waiting for open-heart surgery. It is also called palliative surgery and involves a tube (shunt) between the artery that comes from the aorta and the lung artery. It helps make a new way of blood that goes to the lungs.
- Open-heart surgery (complete repair) – This surgery is used to completely treat heart problems caused by the condition. This procedure involves several steps to get rid of all heart problems (such as a hole between the lower chambers of the heart, pulmonary valve problems, thickened muscle removal, and others).
Frequently Asked Questions
What is the life expectancy of people with tetralogy of Fallot?
Approximately 30% of people with this congenital heart defect live to age 10 and 5% of them may live to 40 years old. However, if the complete repair surgery is done, the chances of living to 30 years old increases to 70%.
What are the defects caused by tetralogy of Fallot?
These include:
- Ventricular septal defect
- Overriding aorta
- Pulmonary stenosis
- Right ventricular hypertrophy
However, people may develop other heart problems as well, previous ones are the most common found in people with tetralogy of Fallot.
Can tetralogy of Fallot be cured?
With treatment, people with this condition may completely fix their heart problems. However, some minor heart problems may appear later in life. If you have additional questions, ask your healthcare provider.
