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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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 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 Chen Guang Yin
Cardiology
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Can Tetralogy of Fallot receive oxygen therapy?

Tetralogy of Fallot is a congenital heart defect that includes abnormalities such as ventricular septal defects, pulmonary valve stenosis, and stenosis of the right ventricular outflow tract. Due to these congenital defects, the ejection of blood from the heart is affected, which in turn impacts the blood supply to various systems and organs throughout the body. The patient may exhibit symptoms of cyanosis and hypoxia, especially after physical activity, hence the use of supplemental oxygen is advisable. While oxygen therapy can temporarily alleviate these hypoxic symptoms, it does not address the underlying issue. Surgery is necessary for a definitive resolution.

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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 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.