Tetralogy of Fallot
Original Editors - Megan Clayton & Jaclyn Muenchow from Bellarmine University's Pathophysiology of Complex Patient Problems project.
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Definition/Description[edit | edit source]
Tetralogy of Fallot is a congenital heart defect which presents with 4 conditions: a ventricular septal defect (a hole between the right and left ventricles), a narrowing of the pulmonary outflow tract (the vessel between the heart and lungs), an overriding aorta (the aorta is shifted to the right instead of being connected strictly to the left side), and hypertrophy of the right ventricle. Each of these components can vary in severity. These defects cause there to be lower oxygen levels in the blood, leading to cyanosis. It is the most common cause of cyanotic cardiac disease in neonates.
http://www.youtube.com/watch?v=yePivAlbR4A.
Prevalence[edit | edit source]
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Characteristics/Clinical Presentation[edit | edit source]
Most babies present with mild to moderate cyanosis, but do not typically present with signs of respiratory distress or heart failure. Symptoms of TOF include:
• cyanosis, which gets worse when the baby is upset
• clubbing of fingers
• fainting
• heart murmurs
• poor appetite and/or slow growth
• tires easily
• has trouble breathing when eating or crying
• squatting episodes during cyanosis
Patients with TOF may experience a hypercanotic spell. They are not common but they can occur in as young as 2 months of age. These spells are characterized by a sudden decrease in oxygen due to acute, almost complete obstruction of subpulmonary outflow. These spells are a medical emergency and can result in death if not treated.
If the child is having a hypercyanotic spell, put his/her knees to chest in order to try to increase venous return to the right side of the heart. Call 911 immediately.
Associated Co-morbidities[edit | edit source]
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Medications[edit | edit source]
Surgery is the first line of defense in children with TOF. Afterwards, they may or may not be on various medications to help control arrhythmias (if they have one) or to help their heart beat more forcefully. Children after TOF surgery may be required to take antibiotics when going to the dentist to get their teeth cleaned, or if they are around someone that has an infection as an act of prophylactic care.
Diagnostic Tests/Lab Tests/Lab Values[edit | edit source]
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Etiology/Causes[edit | edit source]
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Systemic Involvement[edit | edit source]
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Medical Management (current best evidence)[edit | edit source]
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Physical Therapy Management (current best evidence)[edit | edit source]
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Alternative/Holistic Management (current best evidence)[edit | edit source]
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Differential Diagnosis[edit | edit source]
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Case Reports/ Case Studies[edit | edit source]
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Resources
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Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
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