The reason for squatting in Tetralogy of Fallot

Written by Hu Qi Feng
Pediatrics
Updated on September 24, 2024
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The reason for squatting is that when squatting, the lower limbs are bent, which reduces the amount of blood returning to the heart through the veins, thereby reducing the load on the heart. At the same time, the arteries in the lower limbs are compressed, which increases the resistance in the systemic circulation and reduces the right-to-left shunt volume, allowing temporary relief from hypoxia symptoms. Babies who cannot walk often like to be held by adults in a position that bends the lower limbs to reduce the amount of blood returning to the heart. This frequently occurs during walking and playing, often characterized by brief periods of squatting.

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Written by Hu Qi Feng
Pediatrics
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Tetralogy of Fallot Clinical Symptoms

The clinical manifestations of Tetralogy of Fallot include cyanosis, with cyanosis being the primary symptom. The severity of cyanosis is related to the extent of pulmonary stenosis and is commonly seen in areas rich in capillaries, such as the lips, fingertips, nail beds, and conjunctiva, where it appears more pronounced during physical activity or crying. Secondly, the squatting symptom is observed; children may show squatting behavior during walking or playing, often squatting down voluntarily for a moment. During squatting, the flexion of the lower limbs reduces the venous return to the heart, lightening the cardiac load and decreasing the right-to-left shunting, thereby alleviating hypoxia. Thirdly, clubbing of the fingers occurs due to long-term hypoxia, leading to hypertrophic growth at the fingertip and toe ends. Fourthly, paroxysmal hypoxic attacks occur.

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Written by Tong Peng
Pediatrics
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How is Tetralogy of Fallot classified in terms of severity?

Tetralogy of Fallot is a complex congenital heart disease in children, characterized early by cyanosis in the face. The severity of symptoms, which often correlate with the level of pulmonary stenosis, includes cyanosis primarily appearing in regions with abundant capillaries such as the lips, nail beds, and bulbar conjunctiva. This cyanosis worsens with crying or physical activity. Additionally, the presence of squatting behaviors is indicative of more severe conditions. Frequent squatting suggests a substantial disease burden, as bending the legs while squatting reduces the volume of venous return, thereby decreasing the cardiac load and temporarily relieving hypoxic symptoms. In severe cases, symptoms can escalate to paroxysmal respiratory distress and loss of consciousness, often triggered by nursing or vigorous crying. Such difficulties can lead to severe spells including unconsciousness and seizures, primarily due to spasm in the muscular area at the base of the pulmonary artery, causing stenosis. Early detection and treatment of these conditions are crucial to prevent manifestations of heart failure.

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Written by Yan Xin Liang
Pediatrics
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Is tetralogy of Fallot a chromosomal problem?

Tetralogy of Fallot is the most common cyanotic congenital heart disease in childhood, consisting of four defects: ventricular septal defect, obstruction of the right ventricular outflow tract, overriding aorta, and right ventricular hypertrophy. It is a type of congenital heart disease, which generally stems from abnormal cardiovascular development during fetal life, resulting in cardiovascular malformations not controlled by chromosomes. The malformation of the cardiovascular system is mainly caused by genetic factors, environmental factors, and their interactions. The exact cause of this congenital heart disease has not been fully identified yet, indicating that it is not a chromosomal disease but a result of cardiovascular developmental abnormalities during fetal life.

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Written by Yan Xin Liang
Pediatrics
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Tetralogy of Fallot shadow on the radiograph

Tetralogy of Fallot is the most common cyanotic heart disease in children over the age of one, accounting for about 10 percent of all congenital heart diseases. Tetralogy of Fallot includes four anatomical abnormalities: a ventricular septal defect, right ventricular outflow tract obstruction, an overriding aorta, and right ventricular hypertrophy. In patients diagnosed through X-ray, the heart size is often within normal limits, typically appearing boot-shaped, with markedly reduced pulmonary vascular markings. The aortic arch may be located on the right side, and the ascending aorta is usually dilated. Patients with rich collateral circulation display prominent pulmonary markings.

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Written by Hu Qi Feng
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The reason for squatting in Tetralogy of Fallot

The reason for squatting is that when squatting, the lower limbs are bent, which reduces the amount of blood returning to the heart through the veins, thereby reducing the load on the heart. At the same time, the arteries in the lower limbs are compressed, which increases the resistance in the systemic circulation and reduces the right-to-left shunt volume, allowing temporary relief from hypoxia symptoms. Babies who cannot walk often like to be held by adults in a position that bends the lower limbs to reduce the amount of blood returning to the heart. This frequently occurs during walking and playing, often characterized by brief periods of squatting.