Tetralogy of Fallot, described centuries ago by M. Fallot, is characterised primarily by four critical features:
In normal individuals, the left side of the heart pumps blood to the body, and the right side pumps blood to the lungs. In a child with tetralogy of Fallot, there is mixing of blood in the lower chambers of the heart through the hole (VSD). The obstruction in the blood flow (pulmonary stenosis) can also affect the blood supply to the lungs.
The degree of arterial narrowing influences how blood flows across the VSD, potentially bypassing the lungs and leading to insufficient oxygenation and resulting in cyanosis.
The most severe form of this condition is Pulmonary Atresia – VSD, where the pulmonary valve is completely blocked, preventing blood flow to the lungs.
Small babies - especially those with a hole in the heart have an increased food requirement and may need special milk.
Good dental hygiene is essential for children and adults with congenital heart disease, as poor dental health can lead to infections spreading to the heart. Therefore, regular dental check-ups are crucial.
The use of antibiotics before a dental procedure is not routinely recommended unless they meet the following criteria:
Please consult your doctor regarding your condition if you are unsure whether your child requires antibiotics prior to dental procedures.
Children diagnosed with Tetralogy of Fallot, particularly those with residual complications, are advised to engage in light, low-impact physical activities, such as golf and cricket.
Exercise is beneficial, even for those with heart conditions. It improves heart function, overall well-being and is associated with increased life expectancy and reduced heart disease risk in later life. It also aids in weight control and blood pressure reduction.
Different types of exercise, such as static (e.g., weightlifting) and dynamic (e.g., running), have varying impacts on the body and heart. Children with heart conditions should consult their doctor to determine safe levels and types of exercise, especially in school settings where physical activities can be intensive.
Most children with heart disease can follow the standard vaccination schedule. However, those with immune deficiencies, such as DiGeorge syndrome or an isomerism, or those who are receiving immunosuppression, such as post-transplantation, may require a modified vaccination schedule.
Before travelling, especially long distances or to unusual destinations, we recommend to:
Special diets are not normally required for those with heart disease, but a balanced one is important. Maintaining a normal weight is crucial as excess weight increases the heart’s workload.
Children with heart disease are generally not more prone to infections, although some may be susceptible to chest infections or have associated immune deficiencies, particularly those with holes in the heart (ASD, VSD, PDA). Viral infections are common and usually resolve without antibiotics, but medical advice should be sought in case of uncertainty.
Not all children with heart disease require medication. Those who do may need it for fluid reduction, aiding heart pumping, rhythm control or blood thinning.
While these medications are generally safe, side effects can occur, especially with other illnesses or medication changes. Any unusual symptoms or side-should be promptly reported to the doctor.
Most women with heart disease can have a normal pregnancy and delivery. Exceptions may include those with severe cyanosis or pulmonary hypertension, where pregnancy can pose significant risks.
It is essential to seek medical advice before pregnancy so the process can be monitored, and if treatment is necessary, it can be provided early.
The risk of heart disease in offspring varies, with some evidence suggesting that maternal vitamin intake before and during early pregnancy may reduce risks.
