Symptoms of Tetralogy of Fallot

Tetralogy of Fallot is a combined congenital heart and vascular malformation, including pulmonary artery stenosis, ventricular septal defect, right aorta (riding over the defective ventricular septum), and right ventricular hypertrophy. This congenital disease is an unchangeable fact and is an innate disease that requires acquired treatment to return to normal. Let's take a look at the manifestations of tetralogy of Fallot.

One cause

Van Praagh believed that the four malformations of tetralogy of Fallot were the consequence of poor development of the right ventricular infundibulum or cone, that is, the truncus arteriosus did not rotate in the opposite direction in the fourth week of embryogenesis, the aorta remained on the right side of the pulmonary artery, the cone septum shifted forward, and failed to align with the normally positioned sinus ventricular septum, thus forming an underdeveloped infundibulum and subcrista ventricular septal defect, also known as perimembranous ventricular septal defect. If the pulmonary cone is underdeveloped or the cone is completely absent, a subpulmonary ventricular septal defect, also known as a subtruncal ventricular septal defect, will form.

2. Clinical manifestations

1. Symptoms

(1) Cyanosis usually occurs 3 to 6 months after birth, but in some cases it occurs only in childhood or adulthood. Cyanosis worsens with movement and crying and lessens when the child is calm.

(2) Dyspnea and hypoxic attacks usually begin to appear 6 months after birth. Due to tissue hypoxia, the baby's endurance for activities is poor, and breathing becomes rapid when moving. In severe cases, hypoxic attacks, loss of consciousness, or convulsions may occur.

(3) Squatting is a characteristic clinical posture of children with tetralogy of Fallot. Squatting can relieve dyspnea and cyanosis.

2. Physical signs

Children have delayed growth and development and often have clubbing of fingers and toes, which usually occurs months or years after the onset of cyanosis. A coarse jet-like systolic murmur can be heard between the 2nd and 4th intercostal spaces on the left side of the sternum, often accompanied by a fine systolic thrill. In very severe cases of right ventricular outflow tract obstruction or pulmonary atresia, there may be no heart murmur. When there is a continuous murmur in the chest or back, it indicates the presence of abundant collateral vessels and the second heart sound of the pulmonary valve is significantly weakened or disappears.

Three treatments

1. Tetralogy correction surgery

Supine position, general anesthesia, midline chest incision, moderate hypothermic extracorporeal circulation is generally recommended, while deep hypothermic circulatory arrest and low-flow extracorporeal circulation are recommended for neonates. Generally, 4°C cold blood cardioplegia solution is used for coronary artery perfusion to induce cardiac arrest for myocardial protection. Intracardiac corrective operations include ventricular septal defect repair and proper relief of right ventricular outflow tract obstruction.

After reading the above content about Tetralogy of Fallot, the causes, symptoms, and treatments of the disease are introduced in detail. The disease affects congenital patients, and the baby will feel unwell when he is very young. Therefore, if the disease is not detected during the baby's birth physical examination, you must take good care of the baby in the future to detect related diseases as early as possible.