Infants with this condition are sometimes referred to as blue babies because of the presence of cyanosis, an outstanding symptom of tetralogy of Fallot. The cyanosis is due to mixing of poorly oxygenated blood from the systemic circulation with oxygenated blood from the lungs, because of the position of the aorta. Other symptoms include clubbing of the ends of the fingers, hemoptysis, dyspnea on exertion, and a slight delay in growth and development.
Diagnosis is confirmed by electrocardiography, angiocardiography, and cardiac catheterization.
Treatment of tetralogy of Fallot involves surgical correction whenever possible. Without corrective surgery the prognosis is extremely poor for children who are deeply cyanotic and have dyspnea on slight exertion. Before surgery, medical treatment to avoid complications and to control dyspneic attacks is necessary. Since the hematocrit is high and polycythemia is common, efforts must be made to prevent dehydration and avoid the development of thrombi. Paroxysmal dyspnea, which often follows feeding or a spell of crying, usually can be relieved by placing the infant in knee-chest position, administering oxygen, or administering a mild sedative or morphine.