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| The heart works as a pump that keeps the blood
flowing.
| The heart is divided into 4 chambers, two filling
chambers and two pumping chambers.
| The veins drain the
blood into the heart.
The arteries carry
blood away from the
heart
| The chambers and vessels
are separated by valves
that control the blood flow.
A wall of muscle separates
the left and right side of
the heart.
| The red blood carries oxygen around the
body.
| The blue blood is returned to the right
side of the heart, and into the lungs for
more oxygen.
| The blood then flows into the left side of
the heart and is pumped around the
body again.
 
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| There are four major defects in Tetralogy of
Fallot.
| A ventricular septal defect (a hole between
the ventricles) and many levels of obstruction
from the right ventricle to the lungs
(pulmonary stenosis) are the most important.
Also, the aorta (major artery from the heart to
the body) lies directly over the ventricular
septal defect, and the right ventricle develops
thickened muscle.
À




Jentricular Septal
Defect or a "hole in
the heart". This is a
hole in the muscle
between the left and
right pumping
chambers
(ventricles).
¦

 

6arrowing of the
artery from the right
pumping chamber in
the heart to the
lungs. (pulmonary
artery)
Ôw

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The right ventricle

(pumping chamber)
muscle increases in
amount, from working
at high pressure.
 4. OJ

IDI6 OF
AO
TA.

The large artery (aorta)

lies over the top of the
"hole in the heart".
Some of the blue blood
from the right side of the
heart flows through the
hole to the aorta.
It does not go to the lungs
for oxygen.
This blood with little
oxygen is pumped into the
aorta and around the
body.
Õ    
 



| Tetralogy of Fallot occurs during fetal growth,
when the baby's heart is developing. While
factors such as poor maternal nutrition, viral
illness or genetic disorders may increase the
risk of this condition, in the majority of cases
the cause is unknown.
   
While the exact cause of tetralogy of Fallot is unknown, several
factors may increase the risk of a baby being born with this
condition. These include:
| A virus illness of the mother, such as rubella (measles), during
pregnancy
| Maternal alcoholism

| diabetis

| Poor nutrition

| A mother older than 40

| A parent who had tetralogy of Fallot

| Children born with Down syndrome, a genetic condition

resulting from an extra 21st chromosome, are also at increased
risk of having tetralogy of Fallot
Õ    
  
  


| Signs and symptoms of tetralogy of Fallot vary, depending on
the extent of obstruction of blood flow out of the right ventricle
and into the lungs. Typical signs and symptoms may include:
| A bluish coloration of the skin caused by blood low in oxygen
(cyanosis)
| Shortness of breath and rapid breathing
| Loss of consciousness (fainting)
| Clubbing of fingers and toes (an abnormal, rounded shape of
the nail bed)
| Lack of appetite & Poor weight gain
| Tiring easily during play
| Irritability
Œabies with tetralogy of Fallot will
suddenly develop deep blue skin,
nails and lips after crying, feeding
or upon awakening.
These episodes are called "Tet
spells" and result from a rapid
drop in the amount of oxygen in
the blood.
| Toddlers or older
children may
instinctively squat
when they are
short of breath.
Squatting
increases blood
flow to the lungs.
 
 

 
Õ
  
 
Seek medical help if you notice that your baby has the following
symptoms:
| Difficulty breathing

| Œluish discoloration of the skin

| Passing out or seizures

| Weakness

| Unusual irritability

| If your baby becomes blue (cyanotic), immediately place your

child on his or her side and pull the knees up to the chest. This
helps increase blood flow to the lungs.
w  


w
 

| Small, frequent meals may be easier for your baby to handle

| A supplement or an extra feeding can give the baby more
calories, vitamins, or iron
| Lowering your baby's anxiety or stress can help prevent "tet
spells" and save the baby's energy.
| Œring the baby's or child's knees up tight against his or her
chest (this is called the knee²chest position) or have your
child squat down. This will increase blood flow to the lungs
| Some children with tetralogy of Fallot may need to
limit certain types of exercise/activities



| All babies with tetralogy of Fallot need corrective
surgery. Without treatment, your baby may not grow
and develop properly. He or she is also at increased
risk of serious complications, such as infective
endocarditis, an inflammation of the inner lining of the
heart caused by a bacterial infection, or stroke, a
blood clot in the brain.
| Unfortunately, untreated cases of tetralogy of Fallot
usually develop severe complications over time, which
may result in death or disability by early adulthood
| Surgical Treatment
Tetralogy of Fallot is treated surgically. A
temporary operation may be done at first if the
baby is small. Complete repair comes later.
Sometimes, the first operation is a complete
intracardiac repair.
| Temporary Operation
In small and very blue infants, a shunt
operation may be done first to provide
adequate blood flow to the lungs. This
lets the baby grow big enough to have a
full repair. The shunt is built between
the aorta and the pulmonary artery. The
shunt is removed when a complete
intracardiac repair is done later.
| Complete
epair
Complete repair tends to be done early in life.
Once it was more common to do a temporary
operation first and a complete repair later in
childhood.
| To do a complete repair, the surgeon
closes the ventricular septal defect with
a patch and opens the right ventricular
outflow tract by removing some
thickened muscle below the pulmonary
valve, repairing or removing the
pulmonary valve and enlarging the
peripheral pulmonary arteries that go to
both lungs. Sometimes a tube is placed
between the right ventricle and the
pulmonary artery. This is sometimes
called a
astelli repair.
    

| After surgery your baby will require continuing

care.
| routine check-ups to make sure that the
procedure was successful and to monitor for
any new problems.
| limit physical activity

| take antibiotics during dental procedures to

prevent infections.
 


| While there's no known prevention for tetralogy

of Fallot, it's important to follow your doctor's
advice about taking care of yourself during
pregnancy.
| Following a balanced diet and abstaining from
alcohol and tobacco will increase the chances
that your baby will be born healthy.