Tetralogy of Fallot | Diagnosis

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Contact the Congenital Heart Valve Program

At Boston Children's Hospital, we know that the first step in treating your child is forming an accurate, complete and timely diagnosis.

The exam

This pediatric cardiologist will listen to your baby’s heart and lungs, feel the baby’s pulses, measure the oxygen level in the blood (non-invasively) and make other observations that help to determine the diagnosis.

The tests

Your child’s doctor will also use some combination (not necessarily all) of the following medical tests to diagnose ToF:

  • echocardiogram (cardiac ultrasound): An echocardiogram evaluates the structure and function of your child’s heart using electronically recorded sound waves that produce a moving picture of the heart and heart valves. No discomfort is involved. It takes 30-60 minutes. Many younger (less than 3 yrs old) children may need to be sedated. An ultrasound can also detect ToF prenatally.
  • electrocardiogram (EKG): An EKG is used to evaluate the electrical activity of your child’s heart. An EKG is often the initial test for evaluating the causes of symptoms and detecting heart abnormalities. It is performed by placing electrodes on the arms, legs and chest to record the electrical activity. The test takes five minutes or less and involves no pain or discomfort.
  • cardiac magnetic resonance imaging (MRI): A cardiac MRI is a non-invasive test using 3-D imaging technology to accurately determine the shape, size, and function of your child’s heart. No pain is involved, although an IV may be needed. It takes about an hour. Children under 10 years usually need anesthesia.
  • chest x-ray: A conventional chest x-ray will evaluate the size and spatial relationships of the heart within the child’s chest. It takes a few moments. There’s no pain or discomfort.
  • cardiac catheterization: This invasive procedure (a procedure that penetrates the body) performed under sedation or anesthesia provides detailed information and measurements about the structures inside the heart. Blood pressure and oxygen measurements are taken in the four chambers of the heart, as well as the pulmonary artery and aorta. Moving pictures are taken of the heart and blood vessels using x-ray dye to further observe their structure.
  • pulse oximetry: a non-invasive test (a test that doesn’t require penetrating the body) to measure the amount of oxygen in the blood
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