Tetralogy of Fallot symptoms in infants

Written by Hu Qi Feng
Pediatrics
Updated on September 09, 2024
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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.

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Written by Chen Guang Yin
Cardiology
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Is it normal after the complete repair of Tetralogy of Fallot?

Tetralogy of Fallot is a serious congenital heart defect characterized by a ventricular septal defect, pulmonary stenosis, and problems with right ventricular obstruction. It is a congenital disease that can cause hypoxia throughout the body, especially as age increases, the symptoms tend to worsen. After the corrective surgery for Tetralogy of Fallot, it does not mean that the patient is completely normal. Their lifespan is still somewhat impacted. They will not be like patients with simpler congenital heart diseases such as only a ventricular septal defect or atrial septal defect, who can achieve a natural lifespan. For these individuals, their lifespan is still impacted to some extent. As they age post-surgery, some complications may arise, including sudden death, and some may require a second surgery.

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Written by Hu Qi Feng
Pediatrics
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Why does Tetralogy of Fallot squat?

The primary deformity in Tetralogy of Fallot is the obstruction of the right ventricular outflow, which leads to increased right ventricular pressure and a right-to-left shunt causing cyanosis. When the child squats, the flexion of the lower limbs can reduce the return of blood to the heart, alleviating the burden on the right ventricle. At the same time, it can increase systemic circulation resistance, reducing the right-to-left shunt in the heart, thereby alleviating the child's symptoms of hypoxia.

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Written by Hu Qi Feng
Pediatrics
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Tetralogy of Fallot cyanosis cause

Tetralogy of Fallot, due to a ventricular septal defect combined with right ventricular outflow tract narrowing, can display left-to-right, bidirectional, or even right-to-left shunting at the ventricular level. Patients with mild pulmonary stenosis can have left-to-right shunting and usually do not exhibit cyanosis. However, when the pulmonary stenosis is severe, significant right-to-left shunting occurs, and clinically apparent cyanosis becomes evident. Cyanosis is commonly observed in areas rich in capillaries and superficial tissues, such as the lips, fingertips, nail beds, and bulbar conjunctiva.

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Written by Hu Qi Feng
Pediatrics
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Emergency treatment for cyanosis in Tetralogy of Fallot

During hypoxic attacks of Tetralogy of Fallot, for mild cases, adopting the knee-chest position can provide relief. Severe cases should immediately receive oxygen and be given relevant medication treatment. Normally, attention should be paid to removing factors that cause hypoxic attacks, such as anemia and infections, and keep the child as calm as possible. For cases where hypoxia cannot be effectively controlled through the above measures, emergency surgical repair should be considered.

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Written by Yan Xin Liang
Pediatrics
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Is Tetralogy of Fallot hereditary?

Tetralogy of Fallot is a common cyanotic congenital heart disease in children, accounting for about ten percent of congenital heart diseases. It primarily consists of four abnormalities: ventricular septal defect, right ventricular outflow tract obstruction, overriding aorta, and left ventricular hypertrophy. Congenital heart disease is not a hereditary disease; it is not controlled by genes, mainly due to abnormal development of the heart and blood vessels during fetal development, leading to cardiovascular malformations. Thus, this disease is not hereditary.