Management of Hypoxic Episodes in Children with Tetralogy of Fallot

Written by Hu Qi Feng
Pediatrics
Updated on September 04, 2024
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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.

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Written by Hu Qi Feng
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Tetralogy of Fallot's composition and its causes of formation

Tetralogy of Fallot consists of four abnormalities. First, there is a narrowing at the right ventricular outflow, ranging from the entrance of the right ventricular infundibulum to the branches of the left and right pulmonary arteries. Second, there is a ventricular septal defect, characterized by a deficiency around the membranous part that extends towards the outflow. Third, the aorta overrides, where the base of the aorta is enlarged and rotates clockwise to the right, straddling the septal defect. Fourth, right ventricular hypertrophy, which is a secondary lesion.

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Tetralogy of Fallot surgery success rate

Tetralogy of Fallot is a common cyanotic congenital heart disease in children after the age of one. It consists of four abnormalities: ventricular septal defect, obstruction of the right ventricular outflow tract, overriding aorta, and right ventricular hypertrophy. Once Tetralogy of Fallot is diagnosed, the ultimate treatment is surgical. With the development of pediatric cardiothoracic surgery, there are no specific requirements regarding the birth month or weight of the child for the surgery, so the success rate of Tetralogy of Fallot surgery is now very high. If a child has Tetralogy of Fallot, it is crucial to seek active treatment and not to give up.

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Written by Yan Xin Liang
Pediatrics
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The main cause of hypoxic attacks in Tetralogy of Fallot

Tetralogy of Fallot is a complex congenital heart disease, characterized by ventricular septal defect, right ventricular outflow tract obstruction, aorta overriding, and right ventricular hypertrophy. When the obstruction of the right ventricular outflow tract is severe, pulmonary artery blood flow significantly decreases. A large amount of unoxygenated venous blood passes through the ventricular septal defect causing a right-to-left shunt, which clinically manifests as severe cyanosis and increased red blood cells, and different degrees of hypoxia in the systemic circulation. Factors that can induce hypoxic episodes in these infants include feeding, crying, emotional agitation, anemia, infection, etc. These can suddenly lead to fainting, convulsions, or even death. The main reason is generally due to a sudden muscle spasm at the narrow pulmonary artery infundibulum on top of pre-existing stenosis, causing temporary pulmonary artery obstruction and exacerbating cerebral hypoxia, thus leading to severe hypoxic attacks.

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Written by Yao Li Qin
Pediatrics
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Tetralogy of Fallot electrocardiogram manifestations

Tetralogy of Fallot is a common type of cyanotic congenital heart disease, primarily composed of four structural components: first, a ventricular septal defect; second, an overriding aorta; third, hypertrophy of the right ventricle; and fourth, obstruction of the right ventricular outflow tract. When performing an electrocardiogram (ECG) on Tetralogy of Fallot, it often shows right ventricular hypertrophy, and can also display right atrial hypertrophy. Initially, there may be hypertrophy of both the left and right ventricles. As the child develops cyanosis, it progressively evolves into hypertrophy of the right ventricle. These are the typical ECG findings in Tetralogy of Fallot.

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Written by Hu Qi Feng
Pediatrics
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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.