What are the findings of tetralogy of Fallot?
Tetralogy of Fallot is a combination of four congenital heart defects. The four defects are a ventricular septal defect (VSD), pulmonary stenosis, a misplaced aorta and a thickened right ventricular wall (right ventricular hypertrophy). They usually result in a lack of oxygen-rich blood reaching the body.
What is the radiographic appearance of tetralogy of Fallot?
Chest radiographs may classically show a “boot-shaped” heart with an upturned cardiac apex due to right ventricular hypertrophy and concave pulmonary arterial segment. Most infants with tetralogy of Fallot, however, may not show this finding 2. Pulmonary oligemia occurs due to decreased pulmonary arterial flow.
What are the four main anatomic variations that patients with tetralogy of Fallot present with?
The four features typical of tetralogy of Fallot include right ventricular (RV) outflow tract obstruction (RVOTO) (infundibular stenosis), ventricular septal defect (VSD), aorta dextroposition (overriding aorta), and right ventricular hypertrophy.
What is the most common presentation of an infant with tetralogy of Fallot?
Presentation of pediatric patients with tetralogy of Fallot Most infants with tetralogy of Fallot have difficulty with feeding, and failure to thrive (FTT) is commonly observed. Infants with pulmonary atresia may become profoundly cyanotic as the ductus arteriosus closes unless bronchopulmonary collaterals are present.
Why is hematocrit high in tetralogy of Fallot?
Increasing hematocrit is the result of secondary erythrocytosis caused by declining oxygen level in blood, which is related to the oxygen saturation. This study was conducted to find the correlation between oxygen saturation and hemoglobin and hematocrite levels in TOF patients.
Why a wave is absent in TOF?
This phenomenon is typically absent in TOF as the right ventricle is influenced by the left ventricular pressure changes due the presence of unrestrictive VSD.
Does TOF have cardiomegaly?
Although cyanosis and a right-sided aortic arch are associated with tetralogy of Fallot, the presence of cardiomegaly and increased pulmonary vascularity make an admixture lesion the more likely diagnosis.
Why use knee chest in tetralogy of Fallot?
Bring the child’s knees up tight against his or her chest (this is called the knee-chest position) or have your child squat down. This will increase blood flow to the lungs.
Why there is iron deficiency in tetralogy of Fallot?
Background Relative iron deficiency is common among Tetralogy of Fallot (TF) patients and is resulted by inadequate iron supplies for erythropoiesis. The compensatory mechanism is ineffective because the high-elevated hematocrit levels is not accompanied by an increase in oxygen binding capacity.
Why is there a single S2 in TOF?
The 2nd heart sound (S2) is usually single because the pulmonary component is markedly reduced. A prominent right ventricular impulse and a systolic thrill may be present.
Do you have bounding peripheral pulses with tetralogy of Fallot?
Peripheral pulses are normal in most patients, but they may be bounding in patients with exuberant pulmonary blood flow.
What is cyanotic spell?
Cyanotic spells are a paediatric emergency requiring prompt recognition and treatment. Cyanotic spells are paroxysmal hypoxic events in a child due to decreased pulmonary blood flow and right to left shunting. They can occur in any heart condition involving VSD and a restriction to pulmonary blood flow.
Can low iron cause cyanosis?
Cause of cyanosis Cyanosis is caused by an increase in the deoxygenated haemoglobin level to above 5 g/dL. In fact patients who have anemia do not develop cyanosis until the oxygen saturation (also called SaO2) falls below normal haemoglobin levels.
What does split S2 indicate?
The second heart sound (S2) represents closure of the semilunar (aortic and pulmonary) valves (point d). S2 is normally split because the aortic valve (A2) closes before the pulmonary valve (P2). The closing pressure (the diastolic arterial pressure) on the left is 80 mmHg as compared to only 10 mmHg on the right.
Which anatomic abnormalities are found in tetralogy of Fallot?
Understanding Tetralogy of Fallot Tetralogy of Fallot is a heart defect made up of four different heart problems: ventricular septal defect, overriding aorta, pulmonary stenosis and right ventricular hypertrophy. These problems result in cyanotic, or blue, skin on babies because of a lack of oxygen.