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Tetralogy of Fallot – causes, side effects and treatments at

Wednesday, July 04, 2018 by

The tetralogy of Fallot (or ToF, the last word is pronounced fuh-LOW) refers to a rare, yet severe, condition where an infant has four heart defects at birth, which results in oxygen-poor blood to flow out of the heart and the rest of the body. Most infants with the condition have blue-tinged skin, a condition called cyanosis, as a result of the disorder.

Most cases of ToF are diagnosed during infancy or soon after, but some people experience the symptoms and are diagnosed much later in life. If the condition is diagnosed early, and appropriate measures have been undertaken, a lot of people with ToF live relatively normal lives, with only some restrictions on exercise and need for regular medical care.

Known risk factors and symptoms of tetralogy of Fallot

The classic form of ToF includes four defects in the heart, as well as its blood vessels, including:

  • Ventricular septal defect – a hole between the left and right ventricles
  • Narrowed pulmonary outflow tract – This is the valve that connects the heart with the lungs.
  • Overriding aorta – The aorta, the main artery that carries oxygen-rich blood to the body, is shifted to the right ventricle instead of the left.
  • Right ventricular hypertrophy – a thickened right ventricle wall

Like other forms of congenital heart defects, the cause of ToF is unclear. However, certain habits or diseases during pregnancy may increase the risk of the condition.

  • Alcoholism
  • Diabetes
  • Age – Women who are over 40 years old while pregnant are more likely to deliver a child with ToF
  • Poor nutrition during pregnancy
  • Viral infection such as rubella

Children with ToF can also have chromosome disorders, including Down syndrome, Alagille syndrome, and DiGeorge syndrome.

Aside from cyanosis, which is an important sign of ToF, infants may exhibit what is called a “tet spell,” where oxygen levels in the blood drop dangerously low and cause the baby to become blue, after crying or having a bowel movement. ToF in infants can also cause symptoms such as:

  • Difficulty breathing
  • Extreme fatigue and limpness – an infant with ToF will tire easily during feeding. This can lead to less weight gain than healthy infants.
  • Being unresponsive to a parent’s voice or touch
  • Being fussy
  • Passing out

If ToF isn’t treated during infancy, a child would pass out during exercise later on.

Another sign of ToF is the presence of heart murmurs, an unusual sound heard while listening to the heart, because of abnormal blood flow. However, not all heart murmurs are immediate signs of ToF, as these can occur even in healthy children.

Clubbing, the widening or rounding of skin or bone around the tips of the fingers, is another sign of ToF.

Body systems affected by tetralogy of Fallot

The following complications can result in people with ToF.

  • Problems with heart function – Even after an operation to address ToF, the heart muscles will weaken and result in a decreased capacity to pump blood, as well as problems with blood pressure regulation.
  • Arrhythmias – Those with a repaired ToF usually experience disturbances in heart rhythm called arrhythmias. In some cases, this may cause dizziness and fainting; however, more severe cases need pacemakers or implantable defibrillators to regulate the condition.
  • Pregnancy – If a woman with ToF remains cyanotic, pregnancy is a high-risk situation and is not recommended. Even women with a repaired ToF should have a complete examination to determine if there are any adverse risks.

Food items or nutrients that may prevent or relieve tetralogy of Fallot

Little to no information exists on diets that can prevent ToF and other congenital heart defects. However, if a person has ToF, maintaining a healthy heart is an important aspect of good health. Here are some recommended food items for a healthy heart.

  • Almonds. These are rich in vitamin B2, vitamin E, magnesium, and zinc – all of which boost heart health by regulating mood, fighting the side effects of stress, and preventing free radical damage which can lead to heart disease.
  • Asparagus. This vegetable is rich in folate and vitamins C and D, which help reduce inflammation in the body.
  • Beans. The B vitamins, iron, and calcium present in beans support a healthy heart and reduce stress.
  • Blueberries. This fruit is loaded with antioxidants and vitamin C, which reduce cell oxidation that can lead to heart disease.
  • Broccoli. This green vegetable is rich in B vitamins and folic acid, which helps relieve stress and anxiety that can worsen heart conditions such as ToF.
  • Chocolate. Dark chocolate, in particular, contains phenols that reduce the risk of heart disease by preventing fat substances from clogging up the arteries.
  • Leafy greens. These are rich in vitamins C and A, as well as magnesium, which all contribute to better heart health. Some examples include spinach, kale, dandelion greens, turnip tops, and Swiss chard.
  • Sweet potatoes. The crops have potent antioxidants that protect the heart.
  • Salmon and other fish. Most fish are rich in B vitamins, and the omega-3 fatty acids found in salmon are known to be good for the heart.

Treatment and management options for tetralogy of Fallot

If a child is born with ToF, most healthcare professionals will recommend addressing the condition by surgery to improve his condition. This will involve widening the passage of the pulmonary valve and the pulmonary artery, as well as a patch over the ventricular septal defect. These actions will improve blood flow to the body, ensuring infants live healthy lives afterward. However, regular follow-up visits with a cardiologist are necessary to monitor their conditions.

Where to learn more


The tetralogy of Fallot (ToF) is a rare, yet severe, condition where an infant has four heart defects at birth: ventricular septal defect, narrowed pulmonary outflow tract, overriding aorta, and right ventricular hypertrophy.

The etiology of ToF is unclear. However, certain habits or diseases during pregnancy may increase the risk of the condition.

Cyanosis is an important sign of ToF. Another symptom of ToF is a tet spell, where oxygen levels in the blood drop dangerously low and cause the baby to become blue.

Most healthcare professionals address ToF with surgery.

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