What is the role of medications in the treatment of tetralogy of Fallot (TOF)?

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

There is no effective medical treatment for pulmonary insufficiency. Although afterload-reducing agents and diuretics have been attempted, most patients with tetralogy of Fallot (TOF) with pulmonary insufficiency do not show any benefit and the condition continues to progress. If the pulmonary artery pressures are high, some cardiologists place the patient on sildenafil. But long-term studies are lacking on the benefits of this agent in adult patients with tetralogy of Fallot.

For those adults who develop acute cyanosis, place them in a knee-chest position. In addition, provide oxygen and administer intravenous (IV) morphine. IV propranolol can be used in severe cases, as it is known to relax the infundibular muscle spasm and relieve the right ventricular outflow tract obstruction. [6]


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