Congenital heart defect Tetralogy of Fallot – causes, symptoms, diagnostics, treatment of tetralogy of Fallot

Tetralogy of Fallot (TOF)

What is tetralogy of Fallot?

Tetrada Fallo (TF) It is a combination of four heart defects. The disease is present at birth. In the presence of tetralogy of Fallot is deteriorating blood circulation and maintenance of body tissues with oxygen.

Four defect, components of tetralogy of Fallot:

• Ventricular septal defect (VSD) – a hole in the heart wall, which divides its two lower chambers;
• Dekstrapozitsiya aorta – aorta, which is the largest artery of the body, It goes from the left ventricle, but also partially covers or exits from the right ventricle;
• Stenosis of pulmonary artery – restriction of the heart valve, regulating the blood flow from the heart to the lungs;
• Right ventricular hypertrophy – significantly increased muscle size on the right side of the heart.

VSD and dekstrapozitsiya aorta may reduce the amount of oxygen in the blood and tissues. Stenosis of the pulmonary artery and right ventricular hypertrophy can obstruct the flow of blood to the lungs, it also reduces the amount of oxygen in the blood.

Tetralogy of Fallot causes

The heart of the baby develops in the very early stages of pregnancy. The emergence of tetralogy of Fallot caused abnormalities during this period of development. It is not known, Why are there these anomalies. Expected, some of them may be linked to genes, maternal nutrition and exposure to infections. However, for most cases of tetralogy of Fallot causes of unknown.

Risk factors for the appearance of tetralogy of Fallot in the child

Factors, that may increase the risk of TF include:

• Family history;
• Using the mother of retinoic acid;
• Maternal drug fluconazole;
• Alcohol abuse;
• Rubella infection in the mother;
• Pregnancy in older age 40 years;
• Diabetes in the mother.

Some people with tetralogy of Fallot also have a genetic disorder, which may include Down's syndrome , CHARGE syndrome, and VACTERL Association.

Tetralogy of Fallot Symptoms

In most patients, symptoms appear within the first few weeks of life. In children with mild HF symptoms may appear much later. The disease can not be diagnosed until, is an infant or child does not become more active. Physical activity causes great strain on the heart, what, in turn, It causes symptoms.

Symptoms may include tetralogy of Fallot:

• The blue color of the skin and lips, caused by low oxygen levels in the blood;
• Shortness of breath and rapid breathing, caused by low oxygen levels in the blood;
• In older children may experience shortness of breath and fainting during exercise;
• Thickening fingertips.

In severe cases, it may be a sharp worsening of symptoms, in that case, when the oxygen level in the blood falls sharply. Symptoms include:

• It is the blue color of the lips and skin (cyanosis);
• The child has shortness of breath, and he becomes irritable;
• The child becomes lethargic or unconscious, If the oxygen level continues to decline;
• Older children may squat, hugging her knees to her chest, to cope with suffocation.

Diagnosis of tetralogy of Fallot

The diagnosis of tetralogy of Fallot is often made shortly after birth. The doctor will ask about your symptoms and medical history of the child's mother, and perform a physical examination.

The doctor may start a survey based on the child's symptoms. Newborn with blueness of the skin (cyanosis) provided supplemental oxygen. If the oxygen does not remove the symptoms, It may suspect the presence of heart disease. If skin color is normal, It conducted a survey to find a heart murmur.

To take pictures of the internal structures of the child, the following methods:

• Chest X-ray;
• Echocardiogram.

Heart problems can also be detected by cardiac catheterization.

Treatment Tetralogy of Fallot

To relieve the symptoms of tetralogy of Fallot prescribers. They also help prevent complications.

Heart defects are treated by surgery. Surgical options include:

Temporary (palliative) surgery for the treatment of tetralogy of Fallot

Infants with severe tetralogy of Fallot is contraindicated in full operation at an early age. Operation time will increase the amount of oxygen in the blood, which will give the child time to grow up, get stronger and prepare it for operation.

During the time the operation is performed the procedure for creating a vascular anastomosis – şunta, in which the blood is directed past the problem areas of the heart directly to the lungs. This will increase blood flow to the lungs, saturate it with oxygen.

Radical surgery for the treatment of tetralogy of Fallot

Most children with VSD is performed open-heart surgery within the first few years of life. Procedural steps include:

• Closing holes in the heart via “zaplatki”;
• Improved blood flow from the heart to the lungs via one or more of the following methods::
• Removal of all or part of a thickened heart muscle on the right side of the heart;
• Repair or replacement of the valve, allowing blood to flow freely from the heart to the lungs;
• Increasing the size of the blood vessels, which carry blood to the lungs.

In some cases, a shunt is established between the heart and blood vessels, reaching the lungs.

In most cases, the operation is completed successfully. For some patients needed another surgery. After surgery, the patient should always be long-term monitoring, to detect recurring or new problems.

Prevention of tetralogy of Fallot

To date, there are no methods, allowing advance prevent a child tetralogy of Fallot.