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Tetralogy Of Fallot In Children


  • Tetralogy of Fallot, also called TOF, is a congenital heart disease that causes cyanosis (bluish color of the skin). A congenital heart disease is one that a person is born with. Cyanosis occurs when blood from right side of the heart goes directly to the left side. The blood does not pass through the lungs, and it will not carry enough oxygen to give to the body. With TOF, four different problems happen in your child's heart while inside the womb. The first problem is that the wall separating the two ventricles does not completely close, forming a hole. The second problem is that the blood vessel that connects the heart to the lungs is narrowed. The third problem is that the aorta (major artery) abnormally grows from both ventricles, rather than from the left ventricle only. The fourth problem is that the increased backflow of blood causes the muscles of the right ventricle to enlarge and thicken.

  • Problems in the development of your child's heart while inside the womb are thought to cause TOF. These problems may be as a result of infections or the use of certain medicines and alcohol during pregnancy. TOF is diagnosed by echocardiography, blood tests, heart catheterization, chest x-ray, electrocardiogram (ECG), or doppler test. Treatment may include oxygen, medicines, such as heart medicines or diuretics, and surgery. With treatment such as surgery, your child's quality of life may be improved.



  • Keep a current list of your child's medicines: Include the amounts, and when, how, and why they are taken. Bring the list and the medicines in their containers to follow-up visits. Carry your child's medicine list with you in case of an emergency. Throw away old medicine lists. Give vitamins, herbs, or food supplements only as directed.

  • Give your child's medicine as directed: Call your child's healthcare provider if you think the medicine is not working as expected. Tell him if your child is allergic to any medicine. Ask before you change or stop giving your child his medicines.

  • Antibiotics: This medicine is given to fight an infection caused by bacteria. Give your child this medicine exactly as ordered by his healthcare provider. Do not stop giving your child the antibiotics unless directed by his healthcare provider. Never save antibiotics or give your child leftover antibiotics that were given to him for another illness.

  • Diuretics: This medicine may be given to help your child's body and lungs get rid of extra fluid. This can help your child breathe easier. Diuretics may make your child urinate more often.

  • Heart medicine: This medicine may be given to make your child's heart beat stronger or more regularly. There are many different kinds of heart medicines. Talk with caregivers to find out what your child's medicine is and why he is taking it.

Ask for more information about where and when to take your child for follow-up visits:

For continuing care, treatments, or home services for your child, ask for information.


Your child may feel like resting more. He should match his activity to the amount of energy he has. Your child should take naps and rest as much as possible. Give him books or a drawing pad for quiet play. If he has shortness of breath or fatigue, he may not be able to do heavy exercise or sports. Ask your child's caregiver for more information on what activities are best for him to do.


Give your child healthy food from all of the five food groups: fruits, vegetables, breads, dairy products, meats and fish. Eating healthy foods may help your child feel better and have more energy. It may also help your child get better faster. Ask your child's caregiver if your child should be on a special diet.


Give your child 8 to 10 (eight ounce) glasses of liquid to drink each day. Follow the advice of your child's caregiver if you must limit the amount of liquid your child drinks. Good liquids to drink are water, juices, and milk. Limit the amount of caffeine your child drinks. Caffeine may be found in coffee, tea, soda, and sports drinks.

Wellness hints:

  • Oral hygiene: Keep your child's teeth and gums healthy. Ask your child's caregiver if antibiotics should be given when your child is having his teeth cleaned. Antibiotics may also be needed if your child has been exposed to someone with certain infections.

  • Second-hand smoke: Do not let anyone smoke around your child. Smoke can make your child cough or make it hard for him to breathe. Smoke can harm your child's heart, lungs, and blood. Your child is more likely to get lung disease and cancer if people smoke around your child.

  • Vaccines: Have your child vaccinated to help protect him against infections caused by viruses or bacteria. Ask your child's caregiver for more information about vaccinations for your child.

For support and more information:

Accepting that your child has TOF may be hard. You, your child, and those close to you may feel scared, sad, or angry. These are normal feelings. Talk to your child's caregivers, family, or friends about your and your child's feelings. You may also want to join a support group. This is a group of people who also have children with TOF. Contact the following for more information:

  • American Heart Association
    7272 Greenville Avenue
    Dallas , TX 75231-4596
    Phone: 1- 800 - 242-8721
    Web Address:
  • National Heart, Lung and Blood Institute
    Health Information Center
    P.O. Box 30105
    Bethesda , MD 20824-0105
    Phone: 1- 301 - 592-8573
    Web Address:


  • Your child has a fever.

  • Your child has chills, a cough, or feels weak and achy.

  • Your child's skin is itchy, swollen, or has a rash.

  • You have questions or concerns about your child's TOF, medicines, or his treatments.


  • Your child has trouble breathing all of a sudden.

  • Your child has weakness or numbness in an arm, leg, or on his face.

  • Your child's lips or fingernails are blue or white in color.

  • Your child's signs and symptoms get worse.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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