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Definition

Tetralogy of Fallot is a combination of four heart conditions one might have at birth, affecting the structure of the heart. This defect causes oxygen-poor blood to flow out of the heart and to the rest of the body.

This heart defect comprises of four problems.

These four defects are:

Pulmonary Stenosis

Pulmonary means 'of the lungs' and stenosis means narrowing. Pulmonary stenosis is therefore a narrowing at or below the pulmonary valve. This means that blood has difficulty getting from the right ventricle into the pulmonary artery.

Ventricular Septal Defect (VSD)

Ventricular means 'of the ventricles' - the pumping chambers of the heart. Septal means 'of the septum' - the wall between the right and left ventricles of the heart. Defect means a hole. So a VSD is a hole in the wall between the ventricles. This means that blood can leak from one side to the other.

Over-Riding Aorta

The entrance to the aorta, which should only take red (oxygenated) blood around the body, lies over the VSD (the hole), allowing the right ventricle to pump some (deoxygenated) blood directly into it.

Right Ventricular Hypertrophy

The right ventricle becomes thickened (hypertrophy), as it forces blood into the narrowed pulmonary artery.

Symptoms

Symptoms of Tetralogy of Fallot may vary from person to person. These symptoms may include:

  • Loss of consciousness
  • Clubbing of fingers and toes
  • Shortness of breath
  • Bluish coloration in the skin
  • Weight gain
  • Heart murmur
  • Irritability
  • Prolonged crying
  • Tiring easily
  • Weakness
  • Seizures
  • Difficulty breathing
  • Irritability

If your baby shows any/some/all of the above signs, immediate medical attention should be sought.

Risk Factors

The following factors, during pregnancy, can result in a baby having Tetralogy of Fallot:

  • Consumption of excessive alcohol when pregnant
  • Mother aged over 40
  • History of Tetralogy of Fallot in the family
  • Viral illness such as rubella
  • Presence of Down’s syndrome or Di George’s syndrome

Diagnosis

Once a baby is born, if the doctor notices signs of bluish coloration or heart murmur, he might suspect Tetralogy of Fallot. He may conduct a number of tests to confirm his suspicions.

  • Chest X-Ray
  • Oxygen level measurement
  • Echocardiography
  • Electrocardiogram
  • Cardiac catheterization

Depending on the results of these tests, treatment will be prescribed.

Treatment

The only effective methods of treatment for Tetralogy of Fallot is surgery. Surgical procedures may include:

Temporary Surgery: Sometimes, babies have to go through a temporary surgery in order to proceed to intracardiac repair.

Intracardiac Repair: This is an open heart surgery in which the surgeon places a patch over the ventricular septal defect to close the hole between the lower chambers of the heart.

 

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