Tetralogy of Fallot

Tetralogy of Fallot


The most common cyanoticcongenital heart disease consisting of:

1)     Ventricularseptal defect

2)     Pulmonarystenosis

3)     Overridingaorta  

4)     Rightventricular hypertrophy



Associatedwith DiGeorge Syndrome



Failureto thrive



Cyanosis in thefirst few days of life as the ductus arteriosus closes,

Ejection systolic murmur associated withpulmonary stenosis, squatting  

improves cyanosis, clubbing, polycythaemia,hypoxia, right ventricular heave

and harsh S2 heart sound.



ECG: Right axis deviation, rightventricular hypertrophy and right bundle branch block

Chest X-Ray: Boot-shapedheart and decreased pulmonary vasculature

Echo: Toassess for structural abnormality and confirm diagnosis



Hypercyanotic spells: Place in knee-chest position, administeroxygen,

morphine and propanolol

Surgical: Blalock-Taussig shunt to increased pulmonary blood flow, when

 infants aresymptomatic with cyanosis.



Arrhythmias,pulmonary regurgitation, heart failure and infective endocarditis



Patientsgenerally remain asymptomatic post surgical correction and have a

normal life expectancy







Rectangle: Rounded Corners: NOTE FOR PUBLISHERS – 

Diagram of heart showing features of tetralogy of Fallot with labels for the 4 criteria











Figure 1.19 Tetralogy Of Fallot

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