Tetralogy of Fallot Sp b.inggris

8/2/2019 Tetralogy of Fallot Sp b.inggris

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TETRALOGY OF FALLOT

SORAYA VERINA030.10.259


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Definition

Tetralogy of Fallot (TOF) is one of themost common congenital heartdisorders (CHDs). This condition isclassified as a cyanotic heartdisorder, because tetralogy of Fallotresults in an inadequate flow of blood

to the lungs for oxygenation.


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tetralogy of Fallot (TOF) can presentwith a broad range of anatomicdeformities


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EtiologyThe causes of most congenital heart diseases(CHDs) are unknown, but many factors seem to beinvolvedFactors that increase the risk for this conditionduring pregnancy include:

Alcoholism in the motherDiabetesMother who is over 40 years old

Poor nutrition during pregnancyRubella or other viral illnesses during pregnancyChildren with tetralogy of Fallot are more likely tohave chromosome disorders, such as Downsyndrome and DiGeorge syndrome (a condition that

causes heart defects, low calcium levels, and poorimmune function)


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EpidemiologyTetralogy of Fallot (TOF) representsapproximately 10% of cases of congenitalheart disease (CHD), occurs in 3-6 infants

for every 10,000 births, and is the mostcommon cause of cyanotic CHD.This problem is not necessarily fatal.If not treated, the mortality rate is 95% byage 40.Treatment is typically done at age 6-12months.


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phatophysiology

OBSTRUCTION TO FLOW OFDEOXYGENATED BLOOD FROM THERIGHT VENTRICLE TO THEPULMONARY ARTERY

DECREASED OXYGENATION DUE TOPOOR PERFUSION OF THE BLOOD


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Phatophysiology (2)SHUNTING OF DEOXYGENATED BLOODFROM THE RIGHT VENTRICLE TO THE

AORTA ACROSS THE VENTRICULAR

SEPTAL DEFECT (FACILITATED BY AORTIC OVERRIDE)

POOR SYSTEMIC OXYGENATION, LOW HEMOGLOBIN SATURATION ANDCYANOSIS


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SymptomsTetralogy of Fallot symptoms vary, depending on the extentof obstruction of blood flow out of the right ventricle andinto the lungs. Signs and symptoms may include:

- A bluish coloration of the skin caused by blood low inoxygen (cyanosis)- Shortness of breath and rapid breathing, especiallyduring feeding- Loss of consciousness (fainting)- Clubbing of fingers and toes an abnormal, roundedshape of the nail bed- Poor weight gain- Tiring easily during play- Irritability- Prolonged crying- A heart murmur


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Diagnosis

Physical examinationBlood test

Chest x-rayElectrocardiogram


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Physical examination

The infant smaller than expected forage

Cyanosis of the lips and nail bedSquatting positionRV predominance on palpation


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Blood test

In tetralogy of Fallot, the number of red blood cells may be abnormallyhigh (erythrocytosis) as the bodyattempts to increase the oxygen levelin the blood.


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Chest x-ray

A typical sign of tetralogy of Fallot onan X-ray is a "boot-shaped" heart,because the right ventricle isenlarged.


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Electrocardiogram

To determine right ventricle isenlarged (ventricular hypertrophy)and if the heart rhythm is regular.


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Treatment

Surgery is the only effectivetreatment for tetralogy of Fallot.There are two types of surgery thatmay be performed, includingintracardiac repair or a temporaryprocedure that uses a shunt.

- Intracardiac repair- temporary surgery


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Intracardiac repairthe surgeon places a patch over theventricular septal defect to close thehole between the ventricles. He orshe also repairs the narrowedpulmonary valve and widens thepulmonary arteries to increase bloodflow to the lungs. After intracardiacrepair, the oxygen level in the bloodincreases and your baby's symptomswill lessen.


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Temporary surgery

create a bypass (shunt) between theaorta and pulmonary artery. Thisbypass increases blood flow to thelungs. When your baby is ready forintracardiac repair, the shunt isremoved.


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Complications

Delayed growth and developmentIrregular heart rhythms (arrhythmias)

Seizures during periods when there isnot enough oxygenDeath
http://www.ncbi.nlm.nih.gov/pubmedhealth/n/pmh_adam/A003021/http://www.ncbi.nlm.nih.gov/pubmedhealth/n/pmh_adam/A003200/http://www.ncbi.nlm.nih.gov/pubmedhealth/n/pmh_adam/A003200/http://www.ncbi.nlm.nih.gov/pubmedhealth/n/pmh_adam/A003021/

Tetralogy of Fallot Sp b.inggris

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