Tetratogy Fallot is the most common cyanotic heart disease in children. The anatomical definition has four defects:
1 ventricular septal defect,
2 Pulmonary
3 replaces the aorta that a ventricular septal defect
Right ventricular hypertrophy 4
The first three are congenital defects, and the fourth is acquired as a result of increased pressure within the right ventricle.
Embryonic development
The development of defects in tetralogyFallot is the result of abnormal embryonic development of the ventricular septum, the infundibular hypertrophy and division in the results of truncus arteriosus, pulmonary artery and aorta smaller more results.
Hemodynamics altered
Shunting of blood through the ventricular septal defect in the direction from right to left, because the pulmonary blood flow, which hinders the flow of blood to the lungs, causing increased resistance and lungincreased pressure in the right ventricle. A-oxygenated blood is then forced the septum into the left ventricle. The increased load leads to right ventricular hypertrophy. The decreased blood flow to the lungs made, the amount of non-oxygenated blood reaching the systemic circulation.
Alone, associated with pulmonary stenosis and ventricular septal defects in producing cyanosis. Also accentuates the aortic septal defect and accept the non-oxygenated blooddirectly from the right ventricle. The body tries to compensate for the chronic hypoxic polycythemia. However, the result increases the viscosity of blood, the risk of complications such as embolism and cerebrovascular disease.
Clinical manifestation
Infants usually do not show cyanosis because of a patent ductus arteriosus, which shunts blood into the lungs, bypassing the pulmonary stenosis. Anoxic spells become clear when the child exceeds the requirements of oxygenBlood supply, while most of the crying after feeding. Acute episodes of severe cyanosis and hypoxia, often called "blue" or "tet" spells are pulmonary infundibular spasm, which includes all of the sudden flow of blood to the lungs thought. The child takes a typically extended hypotonic.
As the child grows, he learns his duties in accordance with physical disabilities limit. Learn also helps relieve chronic hypoxia knee bends. Usually drawsthis position, standing, sitting or lying down. If lying position can take a knee-chest position as an advanced position, since such an attitude is common in children, should always be suspicious of the tetralogy. Children with less severe cyanosis may be taken only after the exercise squats. The child also shows, clubbing of fingers and a significant delay in the development of physical growth. Results show listened to:
• A holosystolic murmur is usually heard inmiddle left bottom edge of the sternum
• E 'associated with a thrill that feels inferior along the left edge of the sternum.
