Download Tetralogy of Fallot

DR. PUNEET GARG
B.H.M.S., M.D.(Paed.)
Tetralogy of Fallot
1.
A large Ventricular Septal
Defect (VSD)
2.
Pulmonary stenosis
3.
Right ventricular hypertrophy
4.
An overriding aorta
Ventricular Septal Defect
A VSD is a hole in the septum
between the heart's two lower
chambers, the ventricles.
The hole allows oxygen-rich blood
from the left ventricle to mix with
oxygen-poor blood from the right
ventricle.
Pulmonary Stenosis
 This defect involves narrowing of the
pulmonary valve and the passage from the
right ventricle to the pulmonary artery.
 Normally, oxygen-poor blood from the
right ventricle flows through the
pulmonary valve and into the pulmonary
artery. From there, the blood travels to the
lungs to pick up oxygen.
Pulmonary Stenosis(cont.)
In pulmonary stenosis, the
pulmonary valve cannot fully open.
Thus, the heart has to work harder
to pump blood through the valve.
As a result, not enough blood
reaches the lungs
Right Ventricular Hypertrophy
With this defect, the muscle of the
right ventricle is thicker than usual.
This occurs because the heart has
to work harder than normal to
move blood through the narrowed
pulmonary valve.
Overriding Aorta
 This defect occurs in the aorta, the
main artery that carries oxygen-rich
blood from the heart to the body. In a
healthy heart, the aorta is attached to
the left ventricle. This allows only
oxygen-rich blood to flow to the body.
Overriding Aorta(cont.)
In tetralogy of Fallot, the aorta is
located between the left and right
ventricles, directly over the VSD. As
a result, oxygen-poor blood from
the right ventricle flows directly
into the aorta instead of into the
pulmonary artery.
Outcome
With tetralogy of Fallot, not
enough blood is able to reach the
lungs to get oxygen, and oxygenpoor blood flows to the body.
Causes
Some factors that occur during
pregnancy may raise risk of having
a child who has tetralogy of Fallot.
These conditions and factors
include:
German measles (rubella) and
some other viral illnesses
Causes(cont.)
Poor nutrition
Alcohol use
Age (being older than 40)
Diabetes
Heredity
Causes(cont.)
 Children who have certain genetic
disorders, such as Down
syndrome and DiGeorge syndrome
(history of recurrent infection, heart
defects, and characteristic facial
features), often have congenital heart
defects, including tetralogy of Fallot.
Symptoms
 Cyanosis. Cyanosis is a bluish tint to the skin, lips,
and fingernails. Low oxygen levels in the blood cause
cyanosis.
Symptoms(cont.)
 Babies who have unrepaired tetralogy
of Fallot sometimes have "tet spells."
These spells happen in response to an
activity like crying or having a bowel
movement.
 A tet spell occurs when the oxygen
level in the blood suddenly drops.
This causes the baby to become very
blue. The baby also may:
Symptoms(cont.)
 Have a hard time breathing
 Become very tired and limp
 Not respond to a parent's voice or
touch
 Become very fussy
 Pass out
 children would get very tired during
exercise and could faint.
Signs
Heart murmur
The sound occurs because the heart
defect causes abnormal blood flow through
the heart.
 Babies tire easily while feeding.
 Not gain weight or grow as quickly as children
who have healthy hearts.
Clubbing
It is the widening or rounding of the skin
or bone around the tips of the fingers.
Signs(cont.)
Clubbing
It is the widening or rounding of
the skin or bone around the tips of
the fingers.
Diagnosis
Echocardiography
Chest X Ray- shows whether the
heart is enlarged or whether the
lungs have extra blood flow or extra
fluid.
Diagnosis(cont.)
Pulse Oximetry- a small sensor is
attached to a finger or toe (like an
adhesive bandage). The sensor
gives an estimate of how much
oxygen is in the blood.
Diagnosis (cont.)
 Cardiac Catheterization- a thin, flexible
tube called a catheter is put into a vein in
the arm, groin (upper thigh), or neck. The
tube is threaded to the heart.
 Special dye is injected through the catheter
into a blood vessel or one of the heart's
chambers. The dye allows to see the flow of
blood through the heart and blood vessels
on an x-ray image.
Diagnosis(cont.)
cardiac catheterization also done to
measure the pressure and oxygen
level inside the heart chambers and
blood vessels.
Treatment
Tetralogy of Fallot is repaired with
open-heart surgery, either soon
after birth or later in infancy. The
goal of surgery is to repair the four
defects of tetralogy of Fallot so the
heart can work as normally as
possible.
THANKS
DR. PUNEET GARG, M.D.(Hom.)
Lecturer,
Dept. of Medicine,
Bakson Homoeopathic Medical College & Hospital,
Greater Noida, (U.P)- 201306