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What is Tetralogy of Fallot?

Tetralogy of Fallot, or also known as Fallots’s tetralogy, is a heart birth defect involving four anatomical abnormalities of the heart (although only three of them are always present), that prevents the correct blood flow to and from the heart.

While Tetralogy Fallot mostly affect infants; children and adult can be affected by this too. However, since this is a birth defect, some infants may not display enough symptoms to warrant detection. As a result, the condition may keep progressing throughout child and adulthood

Causes and Risk Factors

Doctors believe that this condition is made up of several factors such as;

  • Ventricular septal defect, meaning that a small hole (murmur) has been found between the lower chambers of the heart.
  • Pulmonary Stenosis - shrinkage of the pathway between the pulmonary valve and artery.
  • Ventral septal hypertrophy – this is where the aortic valve that opens to let blood flow to the left ventricle is also allowing blood flow to the right ventricle.
  • Ventricle hypertrophy – this means that there is a thickening of right ventricle of the heart.
  • Lack of maternal nutritional values.
  • Genetic disorders.
  • Viral infections.
  • Maternal alcoholism.
  • Mother’s age.
  • Down syndrome.
  • Di-George syndrome.

Symptoms

Immediate medical attention may be needed if an infant is observed with any of the below symptoms.

  • Cyanosis - facial discoloration due to lack of oxygen and blood.
  • Troubles breathing during feeding times and or physical activities.
  • Club fingers and or toes – an unusual swelling around the finger and toe nails that is round in appearance.
  • Troubles maintaining or gaining weight.
  • Fainting.
  • Excessive crying.
  • Irregular heartbeat.
  • Fussiness.
  • Easily exhausted during activities.

Diagnosis

Diagnosis often starts by the doctor’s evaluation of the baby’s symptoms.

  • Physical exam
  • Echocardiography
  • Electrocardiogram
  • Chest X-ray
  • Pulse Oximetry
  • Heart Catheter

Tetralogy of Fallot Treatment

In almost all cases surgery is the only option.

  • Intracardiac repair. -  is where a patch is surgically placed over a hole in the lower portion of the heart.
  • Pulmonary valve repair.
  • Intracardiac repair.
  •  Surgical shunt placement.
  • Heart bypass.

Surgical Complications

Most infant recover well after these corrective surgeries. But, like all surgeries there are some risks of complications.

Below is a list of possible surgical complications

  • Aortic enlargement otherwise known as (Aortic root dilation).
  • Pulmonary valve regurgitation – this is where the pulmonary valve is unable to close allowing blood to flow backwards into the lower right chamber of the heart.
  • Infective Endocarditic – a bacterial infection that affects the lining of the heart.  

There are often concerns about how activities will affect infants and children with Tetralogy of Fallot. Some parents are worried that their children may not be able to play like other kids do. Although there may be restrictions that in some cases where the condition is more severe, most children are able to adapt and lead a fairly normal life. 

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