What position should be adopted when Tetralogy of Fallot is hypoxic?

Written by Hu Qi Feng
Pediatrics
Updated on September 06, 2024
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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.

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Written by Hu Qi Feng
Pediatrics
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Tetralogy of Fallot Clinical Characteristics

Tetralogy of Fallot is the most common cyanotic congenital heart disease in infancy, accounting for about 12% of all congenital heart diseases. It is caused by malformations of four heart structures: 1. right ventricular outflow tract obstruction; 2. ventricular septal defect; 3. overriding aorta; 4. right ventricular hypertrophy. Its clinical manifestations may include cyanosis, squatting symptoms, clubbed fingers, and paroxysmal hypoxia attacks. Physical examinations generally show delayed development, a prominent precordial area, and at the second to fourth rib interspace along the left sternal margin, a grade 2 to 3 rough systolic murmur can be heard.

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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 Hu Qi Feng
Pediatrics
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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.

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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 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.