Tetralogy of Fallot Symptoms, Tests & Treatments | MedStar Health

A rare combination of four congenital heart defects

Tetralogy of Fallot occurs when a person is born with four heart defects that allow oxygen-poor blood to flow through the body.

Most cases are diagnosed and treated during infancy. However, even if you were treated as a child, you’ll require lifelong monitoring for future complications. Our Adult Congenital Heart Center provides ongoing care so you can stay as healthy as possible. Our team is actively involved in ongoing research to identify complications and management options for people with structural heart defects.

The heart defects that make up tetralogy of Fallot are:

  • Overriding aorta: In a healthy heart, the aorta, the largest artery that carries blood from your heart to the rest of the body, is attached to the lower left chamber of the heart (left ventricle). This defect occurs when the aorta is located between the left and right ventricles, allowing oxygen-poor blood to mix with oxygen-rich blood.

  • Pulmonary stenosis: A defect in which the valve that connects the lower right chamber of the heart (right ventricle) and the pulmonary artery is narrowed, reducing blood flow to the lungs.

  • Right ventricular hypertrophy: In this defect, the muscle that forms the wall of the lower right chamber of the heart (right ventricle) is thicker than normal, causing the heart to have to work harder than normal to pump blood.

  • Ventricular septal defect: This hole in the wall that separates the two chambers on the left side of the heart from the two chambers on the right side (septum), allows oxygen-rich blood to mix with oxygen-poor blood.

Less severe defects may not be diagnosed until adulthood, in which case you may experience:


Our specialists may recommend one or more procedures to diagnose or monitor patients with tetralogy of Fallot.

  • Cardiac Catheterization: Cardiac catheterization is a minimally invasive way to diagnose and treat a variety of heart and vascular conditions by guiding thin, flexible tubes called catheters through blood vessels to problem areas.

  • Chest X-ray: Chest X-rays use a small dose of radiation to create pictures of the structures inside the chest, including the lungs, heart, and chest wall.

  • Computerized Tomography (CT) Scan: The cardiac computed tomography scan, or cardiac CT, uses X-rays to create three-dimensional images of your heart and blood vessels.

  • Echocardiogram: An echocardiogram uses high-frequency sound waves to create images of your heart.

  • Electrocardiogram (ECG):An electrocardiogram, also known as an ECG, measures the heart’s electrical activity.

  • Magnetic Resonance Imaging (MRI): Magnetic resonance imaging, better known as cardiac MRI, is a combination of radio waves, magnets, and computer technology to create images of your heart and blood vessels.

  • Stress Tests: Stress tests are used to assess how your heart works during physical activity. There are several types of stress tests, including treadmill or bike stress tests, nuclear stress tests, stress echocardiograms, and chemically induced stress tests.

  • Transesophageal Echocardiogram (TEE): Transesophageal echocardiogram allows us to take very detailed images of your heart structure from a probe in your esophagus.


If you have tetralogy of Fallot, you’ll likely need surgery to repair the defects and allow blood to flow normally through the heart and to the body. Your doctor also may recommend limiting physical activity and taking antibiotics before certain dental or surgical procedures. They’ll also discuss family planning with women to help them have as healthy a pregnancy as possible.

  • Congenital Heart Disease Treatments: Treatments for congenital heart conditions range from atrial septal defect and patent foramen ovale closures to cardiac ablations and heart valve replacements and heart transplants.

  • Heart Surgery:Heart surgery is an option to treat many heart conditions. You may need heart surgery either as a lifesaving procedure or when other treatments haven’t worked.

  • Structural Heart and Valve Disease TreatmentsStructural heart and valve disease treatments address defects or abnormalities with the heart’s muscle or valves with or without surgery.

  • Valve Disease TreatmentsValve disease treatments include monitoring, medication, or surgery to repair or replace a damaged valve.

Our providers

Dr Brian Case listens to the heart of a patient during an office visit at MedStar Health. Both people are wearing masks.

Expert cardiology care

Getting the care you need starts with seeing one of our cardiologists.

Additional information

Adult congenital heart center

When you’re born with a heart problem, you may need complex care throughout your life. Our experts tailor this specialized care to your unique needs. 

Ask MedStar Heart & Vascular Institute

Have general questions for our heart and vascular program? Email us at AskMHVI@medstar.net. If you have clinically-specific questions, please contact your physician’s office.