Diagnostic Considerations

Wide variation in the basic anatomic morphology, pathophysiology, clinical signs and symptoms, and surgical methods of therapy is noted for tetralogy of Fallot (TOF). Pathophysiology primarily depends on the severity of the right ventricular (RV) outflow tract (RVOT) obstruction. RVOT obstruction determines the severity of right-to-left shunting, which is typical.

Other conditions to consider when evaluating a patient with suspected Tetralogy of Fallot with pulmonary stenosis include acute anemia, asthma and reactive airway disease, bacteremia and sepsis, cardiogenic shock, Ebstein malformation of the tricuspid valve, pseudotruncus arteriosus, pulmonary atresia, septic shock, and ventricular septal defect (VSD).

Differential Diagnoses

Workup

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Author

Michael D Pettersen, MD Consulting Staff, Rocky Mountain Pediatric Cardiology, Pediatrix Medical Group

Michael D Pettersen, MD is a member of the following medical societies: American Society of Echocardiography

Disclosure: Received income in an amount equal to or greater than $250 from: Fuji Medical Imaging.

Chief Editor

Suvro S Sett, MD, FRCSC, FACS Professor of Surgery, Dalhousie University Faculty of Medicine; Head, Division of Pediatric Cardiac Surgery, Izaak Walton Killam Hospital for Children, Canada

Suvro S Sett, MD, FRCSC, FACS is a member of the following medical societies: American College of Surgeons, Congenital Heart Surgeons Society, Western Thoracic Surgical Association

Disclosure: Nothing to disclose.

Acknowledgements

Jeffrey P Jacobs, MD, FACS, FACC, FCCP Clinical Associate Professor, Department of Surgery, University of South Florida College of Medicine; Medical Director, ECMO Program, Division of Thoracic and Cardiovascular Surgery, All Children's Hospital/Bayfront Medical Center

Jeffrey P Jacobs, MD, FACS, FACC, FCCP is a member of the following medical societies: American Association for Thoracic Surgery, American College of Cardiology, American College of Chest Physicians, American College of Surgeons, Congenital Heart Surgeons Society, Society of Thoracic Surgeons, and Southern Thoracic Surgical Association

Disclosure: Nothing to disclose.

Robert DB Jaquiss, MD Professor of Surgery, University of Arkansas for Medical Sciences; Chief, Pediatric Cardiothoracic Surgery, Arkansas Children's Hospital and Chief, Cardiothoracic Surgery, University of Arkansas for Medical Sciences

Robert DB Jaquiss, MD is a member of the following medical societies: American Academy of Pediatrics, American Association for Thoracic Surgery, American College of Cardiology, American College of Surgeons, American Heart Association, Congenital Heart Surgeons Society, International Society for Heart and Lung Transplantation, and Society of Thoracic Surgeons

Disclosure: Nothing to disclose.

Jeff L Myers, MD, PhD Chief, Pediatric and Congenital Cardiac Surgery, Department of Surgery, Massachusetts General Hospital; Associate Professor of Surgery, Harvard Medical School

Jeff L Myers, MD, PhD is a member of the following medical societies: American College of Surgeons, American Heart Association, and International Society for Heart and Lung Transplantation

Disclosure: Nothing to disclose.

Vibhuti N Singh, MD, MPH, FACC, FSCAI Clinical Assistant Professor, Division of Cardiology, University of South Florida College of Medicine; Director, Cardiology Division and Cardiac Catheterization Lab, Chair, Department of Medicine, Bayfront Medical Center, Bayfront Cardiovascular Associates; President, Suncoast Cardiovascular Research

Vibhuti N Singh, MD, MPH, FACC, FSCAI is a member of the following medical societies: American College of Cardiology, American College of Physicians, American Heart Association, American Medical Association, and Florida Medical Association

Disclosure: Nothing to disclose.

Mary L Windle, PharmD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine

Disclosure: Pfizer Inc Stock Investment from broker recommendation; Avanir Pharma Stock Investment from broker recommendation