Tetralogy of Fallot

August 12, 2017 17:51 | Genetic Diseases

Tetralogy of Fallot is the most common type of heart defects blue.It is 12-14% of all congenital heart disease, and 50-75% of blue vices.The first description belongs Stensenu (1673) and Fallot (1888).

In the classic version of tetralogy of Fallot found 4 features: Stenosis (narrowing) of the output card of the right ventricle at different levels, ventricular septal defect, hypertrophy (increase) in the myocardium of the right ventricle and the aorta dekstrapozitsiya.

During systole, blood flows from the ventricle into the aorta both (due to its dekstrapozitsii) and to a lesser extent, to the pulmonary artery (based on the degree of narrowing).Location of the aorta, "riding" on the interventricular septum (dekstrapozitsiya) leads to a smooth release in her blood from the right ventricle.The extent and severity of oxygen starvation of children correlate with the size of the pulmonary artery stenosis.As a result, a large defect is set partitions equal pressure in both ventricles.

Children first days of

life are diagnosed most severe tetralogy of Fallot.Diagnosis is usually established for the first time 6 months.Cyanosis (bluish coloration of the skin) is one of the main signs of tetralogy of Fallot.its time of occurrence and severity are determined by the degree of stenosis (narrowing) of the pulmonary artery.From birth, cyanosis is observed in approximately 40% of cases, most often it becomes apparent to 8-12 months of life by increasing the activity of the child.Almost half of the children with this defect in their first year of life cyanosis is weak or moderate, in part due to concomitant anemia.Sharp cyanosis observed in 13% of cases.The deformation of the nails in an "hour glass" and the fingers of the type "drumsticks" appears depending on the degree of oxygen starvation in the 1-2-year life of the child.Children with Tetralogy of Fallot frequently sit down to squat or lie in bed with those given to the stomach down, thereby facilitating their condition because of reduced inflow of "waste" of blood to the heart.

main manifestation of tetralogy of Fallot, determines the severity of the condition and the development of brain complications are odyshechno-cyanotic episodes.They do not have children in the first three months of life, but they do occur, the most difficult flowing between the ages of 6 to 24 months against the background of anemia.Suddenly, the child becomes restless, worse shortness of breath and blueness of the skin, then the possible loss of consciousness, seizures, and even the development of partial paralysis of one side of the body (hemiparesis).

lag in weight (malnutrition degree II-III) with tetralogy of Fallot occurs quite frequently.For tetralogy of Fallot is characterized by shortness of breath with in-depth, arrhythmic breathing, respiratory rate changes little.Heart hump is absent, as the heart is not greatly increased in size.Auscultation doctor hears a distinctive noise.Heart failure is not typical for tetralogy of Fallot.Heart palpitations and shortness of breath associated with oxygen deficiency.Furthermore, while vice noted enlarged liver and spleen.

The blood tests in children with tetralogy of Fallot revealed anemia.

additional methods of examination of children are ECG, PCG (graphic check heart sounds), chest X-ray, ultrasound of the heart.If necessary, a cardiac catheterization and aortography cavities.

In tetralogy of Fallot may cause complications in the central nervous system (hemiparesis on background odyshechno-cyanotic attacks, brain abscess).Also, sometimes joined by bacterial endocarditis (bacterial defeat inner lining of the heart) and pulmonary tuberculosis.Treatment for tetralogy of Fallot is an operation to correct existing anatomical defects.

known that odyshechno-cyanotic episodes are temporary episode with tetralogy of Fallot and tested after three years of a child's life, when the symptoms of iron deficiency disappear.The pediatrician should take into account all the points that trigger attacks in the child, in order to avoid as much as possible of the operation.This requires an active treatment of opportunistic diseases (anemia, rickets, etc..), Consultation neurologist and medical treatment.