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Tetrology of Fallot
What
is Tetralogy of Fallot? Tetralogy of Fallot is a name given to a
complex of four cardiac malformations when they appear together:
For practical
purposes, however, the signs and symptoms of Tetralogy
of Fallot depend on the Ventricular Septal Defect and the degree of Pulmonary Stenosis. The VSD is a large hole in the wall between the
ventricles. Pulmonary Stenosis is a narrowing in
the outlet from the right ventricle to the pulmonary artery. With more severe
degrees of Pulmonary Stenosis, the right ventricle
delivers less and less blood to the arteries to the lungs for oxygenation.
With increasing degrees of pulmonary stenosis, more
and more of this blue blood (lacking oxygen) is directed away from the lungs,
through the Ventricle Septal Defect, and back to
the left ventricle and out to the body. Thus, as the Pulmonary Stenosis becomes increasingly narrowed, the patient
becomes more blue. What
are the warning signs and symptoms of Tetralogy of Fallot? The most
common warning signs and symptoms of Tetralogy
appear in a newborn or young infant and include:
Occasionally,
early on, the degree of Pulmonary Stenosis will be
very mild and the symptoms will be that of a Ventricular Septal
Defect, including labored breathing, poor feeding, and poor weight gain. How
is Tetralogy of Fallot
detected? Usually Tetralogy patients are initially referred for evaluation
because of a heart murmur or cyanosis. This leads to performing an
echocardiogram and the diagnosis of Tetralogy is
documented. Occasionally, a cardiac catheterization with angiography is
needed prior to surgery to obtain more detailed anatomical information. What
are the treatment options for Tetralogy of Fallot? Patients with
Tetralogy of Fallot
generally undergo surgery in infancy. Most often a complete repair is
performed with patch closure of the Ventricular Septal
Defect and widening of the outflow from the right ventricle to the pulmonary
artery. Occasionally it is too dangerous to perform open-heart surgery on a
particular infant and a temporizing surgery is performed called a shunt,
which allows more blood to flow to the lungs. The open-heart repair is then
deferred until the patient gets bigger. Occasionally
infants will have periods of inconsolable crying accompanied by a severe
increase in cyanosis (called "Tet
Spells") requiring immediate notification to the child's physician. |
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