Do I have Tetralogy of Fallot?
More information about symptoms of Tetralogy of Fallot and related conditions:
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Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.
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The degree of pulmonary stenosis, interacting with the VSD’s size and location, determines the clinical and hemodynamic effects of this complex defect. The VSD usually lies in the outflow tract of the right ventricle and is generally large enough to permit equalization of right and left ventricular pressures. However, the ratio of systemic vascular resistance to pulmonary stenosis affects the direction and magnitude of shunt flow across the VSD. Severe obstruction of right ventricular outflow produces a right-to-left shunt, causing decreased systemic arterial oxygen saturation, cyanosis, reduced pulmonary blood flow, and hypoplasia of the entire pulmonary vasculature. Increased right ventricular pressure causes right ventricular hypertrophy. Milder forms of pulmonary stenosis result in a left-to-right shunt or no shunt at all.
Generally, the hallmark of the disorder is cyanosis, which usually becomes evident within several months after birth but may be present at birth if the neonate has severe pulmonary stenosis. Between ages 2 months and 2 years, children with tetralogy of Fallot may experience cyanotic or “blue’’ spells. Such spells result from increased right-to-left shunting, possibly caused by spasm of the right ventricular outflow tract, increased systemic venous return, or decreased systemic arterial resistance.
Exercise, crying, straining, infection, or fever can precipitate blue spells. Blue spells are characterized by dyspnea; deep, sighing respirations; bradycardia; fainting; seizures; and loss of consciousness. Older children may also develop other signs of poor oxygenation, such as clubbing, diminished exercise tolerance, increasing dyspnea on exertion, growth retardation, and eating difficulties. These children habitually squat when they feel short of breath; this is thought to decrease venous return of unoxygenated blood from the legs and increase systemic arterial resistance.
Children with tetralogy of Fallot also risk developing cerebral abscesses, pulmonary thrombosis, venous thrombosis or cerebral embolism, and infective endocarditis.
In females with tetralogy of Fallot who live to childbearing age, incidence of spontaneous abortion, premature births, and low birth weight rises.
Source: Professional Guide to Diseases (Eighth Edition), 2005
Heart murmur in the newborn period:
Source: The 5-Minute Pediatric Consult, 2008
These general reference articles may be of interest in relation to medical signs and symptoms of disease in general:
Full list of premium articles on symptoms and diagnosis
The symptom information on this page attempts to provide a list of some possible signs and symptoms of Tetralogy of Fallot. This signs and symptoms information for Tetralogy of Fallot has been gathered from various sources, may not be fully accurate, and may not be the full list of Tetralogy of Fallot signs or Tetralogy of Fallot symptoms. Furthermore, signs and symptoms of Tetralogy of Fallot may vary on an individual basis for each patient. Only your doctor can provide adequate diagnosis of any signs or symptoms and whether they are indeed Tetralogy of Fallot symptoms.
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