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Tetralogy of Fallot
Tetralogy of Fallot symptoms in infants
Infants with Tetralogy of Fallot often exhibit the following symptoms: First, cyanosis, which is most apparent in areas rich in capillaries such as the lips, fingernail beds, and conjunctiva. Cyanosis tends to worsen gradually during crying, emotional distress, or physical exertion. Second, squatting symptoms; infants who cannot walk often prefer to be held by adults in a flexed position of both lower limbs, reducing venous return and easing the cardiac workload. Older children often exhibit squatting during activities such as walking and playing, frequently squatting down momentarily. Third, infants in a prolonged hypoxic environment may develop clubbing, characterized by the enlargement of the fingertips and toes, with capillary expansion and proliferation, resembling drumsticks. Fourth, episodic hypoxia occurs predominantly in infants, triggered by feeding, crying, or emotional distress, manifesting as episodes of respiratory difficulty, with severe cases leading to sudden fainting or convulsions.
Tetralogy of Fallot is what?
Tetralogy of Fallot is the most common cyanotic congenital heart disease in infants, accounting for about twelve percent of all congenital heart diseases. It was thoroughly described by the French physician Fallot in 1888, which is how it got its name. Tetralogy of Fallot consists of four cardiac malformations: first, obstruction of the right ventricular outflow tract; second, ventricular septal defect; third, overriding aorta; fourth, right ventricular hypertrophy.
Is Tetralogy of Fallot serious?
Tetralogy of Fallot is the most common cyanotic congenital heart disease in children, accounting for about 10% of congenital heart diseases. It is a complex type of congenital heart condition, consisting of four defects: a ventricular septal defect, right ventricular outflow tract obstruction, overriding aorta, and right ventricular hypertrophy. Due to these four malformations, children will experience cyanosis, poor exercise tolerance, and may quickly become fussy or emotionally disturbed with physical activity. This can lead to noticeable worsening of dyspnea and cyanosis. They may also exhibit a preference for squatting, as squatting can decrease the return blood volume to the heart, increase systemic vascular resistance, and temporarily relieve hypoxic symptoms. Other symptoms include clubbing, paroxysmal hypoxia attacks which are more common in infants. These attacks can be triggered by crying, emotional excitement, anemia, infections, etc., and suddenly manifest as paroxysmal breathing difficulties. In severe cases, there can be fainting, convulsions, and even death. Therefore, these clinical manifestations are very serious, making this disease a significantly dangerous condition.
What position should be adopted when Tetralogy of Fallot is hypoxic?
Treatment of hypoxic episodes in Tetralogy of Fallot: For mild cases, assuming the knee-chest position can alleviate symptoms. Severe cases require immediate oxygen administration and relevant drug therapy. Routinely, it is important to actively eliminate factors that trigger hypoxic episodes, such as anemia and infections, and maintain the child's tranquility. If the above treatments do not effectively control the episodes, emergency surgical intervention for repair or definitive treatment should be considered.
Management of Hypoxic Episodes in Children with Tetralogy of Fallot
In the treatment of hypoxic episodes in children with Tetralogy of Fallot, mild cases can be alleviated by positioning the child in a knee-chest position, while severe cases should receive immediate oxygen therapy, along with appropriate medication to correct acidosis. It is important to regularly eliminate factors that may trigger hypoxic episodes, such as anemia and infections, and to maintain a calm environment for the child. If these measures do not effectively control the episodes, emergency surgical repair should be considered.
Tetralogy of Fallot Emergency Measures
Generally, one should often drink water to prevent infection, prevent dehydration and complications. Infants and young children should be especially careful in their care, to avoid episodes of paroxysmal hypoxia. In mild cases of hypoxic episodes, placing them in a knee-chest position can alleviate the symptoms. In severe cases, oxygen should be administered immediately, along with the appropriate drug treatment. If the episodes cannot be effectively controlled with medication, emergency surgical intervention may be necessary. With the continuous improvement in surgical techniques this year, the mortality rate for curative surgeries has been decreasing.
Tetralogy of Fallot Common Symptoms
The clinical manifestations of Tetralogy of Fallot include, firstly, cyanosis as the primary clinical symptom. The degree and onset of cyanosis are related to the severity of pulmonary stenosis, and it often appears in areas with abundant capillaries such as lips, fingers, toes, nail beds, and bulbar conjunctiva. Secondly, squatting symptoms are common among children; they often spontaneously squat for a while during walking or playing. Squatting, with the legs bent, reduces the venous return and thus decreases the load on the heart, temporarily relieving symptoms of hypoxia by reducing the right-to-left shunt. Thirdly, clubbing occurs due to long-term hypoxic conditions, which can cause capillary dilation and proliferation in the fingers and toes, and the local soft tissues and bones also grow and enlarge; fourthly, paroxysmal hypoxic attacks, which are most common in infants, can be triggered by breastfeeding, crying, emotional excitement, or anemia. These attacks suddenly occur and can lead to severe symptoms including difficulty breathing, fainting, convulsions, and even death.