Which clinical history findings are characteristic of tetralogy of Fallot (TOF) in adults?

Updated: Nov 13, 2018
  • Author: Shabir Bhimji, MD, PhD; Chief Editor: Yasmine S Ali, MD, FACC, FACP, MSCI  more...
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Answer

The clinical features of tetralogy of Fallot (TOF) in the adult are directly related to the severity of the anatomic defects. 

Even after surgery it is important to understand that despite the curative approach to surgery, it is simply a long-term palliative procedure. The surgery only corrects the anatomic abnormality; it does not address the cause and does not prevent the ongoing anatomic changes in the RV and pulmonary vessels. Hence, sooner or later, most patients with corrective surgery will present with some type of symptom related to dysfunction of the RV and RVOTO. [21]

The majority of patients with repaired tetralogy of Fallot remain symptom free for at least the first two decades following the initial surgery. Mild pulmonary valve insufficiency may appear after the second decade of life and is often asymptomatic. However, with time, the pulmonary valve insufficiency become severe and patients do become symptomatic. Chief complaints at that time may include lack of exercise endurance, palpitations, and a gradual decline in bodily functions.


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