On this date in 1846, English physician Thomas Bevill Peacock described four congenital heart defects often occurring together. These four defects would become known as the tetralogy of Fallot. These are: a ventricular septal defect or VSD; pulmonary stenosis, right ventricular hypertrophy and overriding of the aortic valve. VSD occurs when there is a hole between the two bottom chambers, or ventricles, of a newborn’s heart. Pulmonary stenosis occurs when the area at or just below the pulmonary valve narrows. Right ventricular hypertrophy happens when the aorta is over the VSD, rather than in the left ventricle where it should be. Finally, the right ventricle in infants born with this defect is more muscular than usual. Usually, children with tetralogy of Fallot have “blue" or “tet” spells. These occur because the amount of blood getting to the lungs is vastly reduced. Open-heart surgery is usually performed between six and 12 months, mostly to remove unnecessary heart muscle and to repair the VSD. Sometimes, these babies also need a shunt to increase blood flow to the lungs. Still others need the pulmonary valve to be widened with a graft or patch.

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