Sometimes tetralogy of Fallot goes undiagnosed for several months to a year. Diagnosing conditions such as tetralogy of Fallot is one of the goals of routine checkups with your doctor. Take your child to his or her health care provider if the child develops a bluish color, has breathing difficulties, seizures, fainting, fatigue, slow growth, or developmental delay. A medical professional should establish the cause of these problems.

If you cannot reach your child's health care provider or if the child develops any of the following symptoms, take the child to a hospital emergency department right away:

• Bluish discoloration
• Trouble breathing
• Seizures
• Fainting
• Extreme fatigue or weakness

If your child starts to turn blue, place the child on his or her back in the knee-to-chest position and call 911 or your local emergency number.

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Your health care provider should schedule regular follow-up visits for your child. At these visits, the child should be checked for abnormal heart rhythms, which may develop in children who have undergone surgical correction for tetralogy of Fallot.

After successful surgery, children generally don't have any symptoms and lead normal lives with few, if any, restrictions. However, the surgery itself may have some long-term complications. These include the following:

• Right ventricular failure:Right ventricular failure is possible, especially if surgery created severe pulmonary valve insufficiency, that is regurgitation of blood backwards from the pulmonary artery into the right ventricle.
• Electrical conduction abnormalities:Every patient with tetralogy of Fallot has right bundle branch block secondary to the congenital ventricular septal defect. But sewing the patch into the ventricular septum can create heart block or failure  of the upper atria to conduct/communicate with the lower ventricles. A permanent pacemaker is occasionally needed.
• Arrhythmias:Because of surgery on the ventricles, postoperative ventricular tachycardia (VT) is an infrequent risk. This is a life-threatening arrhythmia, so follow-up detection of risk for ventricular   tachycardia is important.
• Residual hole in the ventricular septum:This is also possible, with oxygenated blood passing from the left side of the heart to the right (shunting).

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