Paediatric Cardiac Care  ·  Pune  ·  Maharashtra
Conditions We Treat

Tetralogy of Fallot

Four features together — the condition many families know as blue baby.

What is Tetralogy of Fallot?

Tetralogy of Fallot (TOF) is a combination of four related heart differences occurring together: a hole between the ventricles, a narrowing on the way to the lungs, a thickened right ventricle, and the aorta positioned slightly differently than usual. Together, they mean some blood bypasses the lungs without picking up oxygen, which is what causes the blue-tinged skin many families are told to watch for.

It is one of the more common serious congenital heart defects, and while the diagnosis can sound frightening, it is also one of the most established and well-treated — most children go on to live active, full lives after surgery.

Signs that may point to it

Bluish tinge to lips, tongue or fingertips (cyanosis), which may worsen with crying or feeding
Episodes of sudden, deeper blueness with irritability ("blue" or "tet" spells) — needs urgent medical attention
A loud murmur
Poor feeding or weight gain
Squatting or tiring quickly, more often noticed in older, undiagnosed children

How it is diagnosed and treated

Tetralogy of Fallot is often picked up on a fetal echocardiogram before birth, or on a newborn echo prompted by a murmur or blue colouring. The scan defines the exact anatomy, which shapes the surgical plan.

Treatment is surgical — usually in infancy, sometimes with a smaller interim procedure first if a baby needs more time to grow. After repair, children are followed long-term, since some need further attention to the pulmonary valve as they grow into adulthood. This is lifelong follow-up, not lifelong illness — most children thrive.

Common questions

What is a "blue spell" and what should I do?
A tet spell is a sudden episode of deeper blueness, often with distress, that needs urgent medical attention. If you have been shown a calming position for your child, use it and seek emergency care immediately.
Is surgery always needed?
Yes, Tetralogy of Fallot is a surgical condition. The timing and exact procedure depend on your child's specific anatomy and how they are doing.
Will my child need more surgery later in life?
Many children do well with one repair. Some need a further procedure on the pulmonary valve years later — this is followed for, not sprung as a surprise.

Questions About Your Child?

Call us, or come in with the report you have been given. We would rather answer a question than have you worry about it.