Children born with this disease are typically not evidently blue right away because the narrowing of the outlet of right ventricle may not be initially severe. Occasionally, the obstruction of blood flow to the lungs become severe enough to significantly reduce blood flow to the lungs, which means very little blood carrying oxygen will return from the lungs causing striking intensification of the bluish discoloration of the child who may faint. This may occur when the child becomes agitated and is termed Hypercyanotic or tetralogy spell tet spell. Such spells typically occur in children older than six months of age. Tetralogy of Fallot is incompatible with normal life.
Surgical repair is the only treatment available.
This is done at about 6 to 9 months of age. Some centers perform repair earlier. The surgery is an open heart surgery. The surgeon enlarges the RVOT and pulmonary valve openings, thus relieving the obstruction to blood flow. The VSD is closed with a patch.