Tetralogy of Fallot

2 week-old baby boy with prenatal diagnosis of Tetralogy of Fallot. Discharged home at DOL3, last echo showed TOF with a large VSD, peak right ventricular outflow tract gradient of 60mmHg, good biventricular function. Saturations on home monitor had been around 80% but over the past day they have been in the 60s and 70s and the mother feels the child looks more cyanotic. Baby has been feeding and making diapers. IV was placed when the baby was in the triage area and the saturations since arrival to the ED have been in the 60s. Scenario begins with a notably cyanotic infant with a saturation of 55% who is tachycardic with a normal blood pressure. Overall goal is to perform the objectives below, call the cardiology fellow and have the infant admitted to the CICU.

Additional information




Children's National

Case Setting

Emergency Department


Emergency medicine, Pediatrics




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