Description

Tetralogy of Fallot (teh-KEY-uh-jee of fuh-LOW) is a rare disease of the heart that is present at birth. That means that it is a congenital defect of the heart. A baby born with the condition have four different heart problems.

These heart problems affect the structure of the heart. The condition that alters the flow of blood through the heart and the rest of the body. Infants with tetralogy of Fallot, often blue or gray color of the skin due to low oxygen levels.

Tetralogy of Fallot is diagnosed during pregnancy or soon after birth of the baby. If the heart of the changes and the symptoms are mild, tetralogy of Fallot may not be noticed or diagnosed until adulthood.

People who are diagnosed with tetralogy of Fallot surgery is needed to repair the heart. They will need regular medical checkups for life.

Symptoms

Tetralogy of Fallot symptoms depend on the amount of blood that block the flow out of the heart to reach the lungs. Symptoms may include:

  • Blue or gray skin color.
  • The shortness of breath and rapid breathing, especially during diet or exercise.
  • Failure to gain weight.
  • Tire easily during the game or exercise.
  • Irritability.
  • Crying for long periods of time.
  • Fainting.

Tet spells

Some children with tetralogy of Fallot, suddenly developed a deep blue or gray skin, the nails and the lips. This usually happens when the baby cries, eats, or is annoying. These episodes are called tet spells.

Tet spells are caused by a rapid drop in the amount of oxygen in the blood. They are more common in young babies, from about 2 to 4 months of age. Tet spells may be less noticeable in young children and older children. That is because normally squat when you're short of breath. Squat sends more blood to the lungs.

When to see a doctor

Serious congenital heart defects are often diagnosed before or shortly after the birth of your child. Seek medical help if you notice that your baby has these symptoms:

  • Difficulty breathing.
  • Bluish Color of the skin.
  • The lack of surveillance.
  • Seizures.
  • The weakness.
  • More irritable than usual.

If your baby turns blue or grey, your baby is placed on the side and pull the baby's knees to chest height. This helps to increase the flow of blood to the lungs. Call 911 or the local emergency number immediately.

Causes

Tetralogy of Fallot occurs as the heart of the baby grows during pregnancy. Usually, the cause is unknown.

Tetralogy of Fallot involves four problems with the structure of the heart:

  • The narrowing of the valve between the heart and the lungs, called pulmonary valve stenosis. This condition reduces the flow of blood from the heart to the lungs. The narrowing may involve the valve. Or it may occur in more than one place along the pathway between the heart and the lungs. Sometimes the valve is not formed. In its place, a solid sheet of tissue that blocks the flow of blood from the right side of the heart. This is called pulmonary atresia.
  • A hole between the bottom chambers of the heart, is called a ventricular septal defect. A ventricular septal defect changes how blood flows through the heart and the lungs. The oxygen-poor blood in the right lower part of the mixing chamber with the oxygen-rich blood in the bottom left of the camera. The heart has to work harder to pump blood through the body. The problem can weaken the heart over time.
  • The displacement of the body's main artery. The main artery of the body is called the aorta. It is usually attached to the lower left chamber of the heart. In the tetralogy of Fallot, the aorta is in the wrong place. Is displaced to the right and is located directly above the hole in the wall of the heart. This changes the way in which the blood flows from the aorta to the lungs.
  • The thickening of the right lower chamber of the heart, called the right ventricular hypertrophy. When the heart has to work very hard, the wall of the right lower chamber of the heart is thick. With time, this can cause the heart to weaken and fail.

Some people with tetralogy of Fallot have other problems that affect the aorta or the arteries of the heart. It can also be a hole between the upper chambers of the heart, called an atrial septal defect.

Risk factors

The exact cause of tetralogy of Fallot is unknown. Some things can increase the risk that a baby will be born with tetralogy of Fallot. The risk factors include:

  • The history of the family.
  • Having a virus during pregnancy. This includes rubella, also known as the German measles.
  • Drinking alcohol during pregnancy.
  • Eating poorly during pregnancy.
  • Smoking during pregnancy.
  • Maternal age greater than 35 years.
  • Down syndrome or DiGeorge syndrome in the baby.

Complications

Without treatment, the tetralogy of Fallot, usually leads to life-threatening complications. Complications can cause disability or death in early adulthood.

A possible complication of tetralogy of Fallot is an infection of the inner lining of the heart or of the heart valves. This is called infective endocarditis. Sometimes antibiotics are given before dental work to prevent this type of infection. Ask your health care team if the use of preventive antibiotics are appropriate for you or your baby.

The complications are also possible after the surgery for the repair of tetralogy of Fallot. But most of the people do well after the surgery. When complications occur, they can include:

  • Retrograde flow of the blood through a heart valve.
  • Irregular heart beats.
  • A hole in the heart that does not go away after the surgery.
  • Changes in the size of the cavities of the heart.
  • Swelling of the part of the aorta is called aortic root dilatation.
  • The sudden cardiac death.

Another procedure or surgery may be needed to correct these complications.

Congenital heart defects and pregnancy

People who are born with a complex congenital heart defect may be at risk of complications during pregnancy. Talk with your health care team about the possible risks and complications of pregnancy. Together, you can discuss and plan for you requires some special care.

Prevention

Because the exact cause of most congenital heart defects is unknown, it may not be possible to prevent these conditions. If you have a high risk of giving birth to a child with a congenital heart defect, genetic testing and screening can be done during pregnancy.

There are some steps you can take to help reduce your child's overall risk of birth defects, such as:

  • Obtaining proper prenatal care. Regular check-ups with a team of health during pregnancy can help to keep mom and baby healthy.
  • Take a multivitamin with folic acid. Take 400 micrograms of folic acid daily has been shown to reduce birth defects in the brain and the spinal cord. You can help reduce the risk of congenital heart defects as well.
  • Do not drink or smoke. These lifestyle habits can affect the health of the baby. Also avoid second-hand smoke.
  • Get a rubella (German measles) vaccine. An infection of rubella during pregnancy can affect the baby's heart development. Get vaccinated before you try to get pregnant.
  • The Control of sugar in the blood. If you have diabetes, good control of your blood sugar can reduce the risk of congenital heart defects.
  • Manage chronic health conditions. If you have other medical conditions, including phenylketonuria (pku), talk with your health care team about the best way to treat and manage them.
  • Avoid harmful substances. During pregnancy, have someone do any painting and cleaning with strong odors of the products.
  • Check with your health care team before taking any medication. Some medicines may cause birth defects. Tell your health care team about all the medicines you are taking, including those bought without a prescription.

Diagnosis

Tetralogy of Fallot is often diagnosed soon after birth. Your baby's skin may appear blue or gray. A whooshing sound may be heard when listening to the baby's heart with a stethoscope. This is called a heart murmur.

Tests

Tests to diagnose tetralogy of Fallot are:

  • The level of oxygen in the measurement. A small sensor placed on a finger or toe quickly checks the amount of oxygen in the blood. This is called a pulse oximetry test.
  • The echocardiogram. This test uses sound waves to create images of the heart in motion. Shows the heart and the heart valves and how well they are working.
  • Electrocardiogram, also called an ECG or EKG. This test records the electrical activity of the heart. It is shown how the heart is beating. Sticky patches called electrodes to go in the chest and sometimes the arms or legs. The cables connect the patches to a computer. The computer prints or displays the results. An electrocardiogram can help to diagnose an irregular heartbeat. Changes in the heart of the signals can also be due to an enlargement of the heart.
  • X-ray of the chest. A chest x-ray shows the shape and condition of the heart and the lungs. A common sign of tetralogy of Fallot in an X-ray is a startup in the shape of a heart. That means that the right lower chamber is too large.
  • The cardiac catheterization. This test helps to diagnose or treat certain heart diseases. That can be done to plan the surgery. The doctor inserts one or more thin, flexible tube into a blood vessel, usually in the groin area. Tubes are called catheters. The doctor guides the tube to the heart. During the test, doctors can do a different heart tests or treatments.

Treatment

To all the babies who have tetralogy of Fallot surgery is needed to repair the heart and improve blood flow. A heart surgeon, called a cardiovascular surgeon, what the surgery. The time and type of surgery depends on the baby's overall health and specific heart problems.

Some babies or small children are given the medicine while waiting for the surgery to maintain the flow of blood from the heart to the lungs.

Surgery or other procedures

The surgery is used to treat tetralogy of Fallot may include:

  • Temporary surgery, also called temporary repair.Some children with tetralogy of Fallot temporary need of surgery to improve the flow of blood to the lungs while waiting for open heart surgery. This type of treatment is called palliative surgery. A surgeon places a tube called a shunt between a large artery that branches off the aorta and the pulmonary artery. The tube creates a new path for the blood to reach the lungs. This surgery can be done if a baby is born before its time, or if the lung arteries are not fully developed. The shunt is removed during open-heart surgery to treat tetralogy of Fallot.
  • Open-heart surgery, called a complete repair.People with tetralogy of Fallot need of open-heart surgery to completely fix the heart. A complete repair is usually performed in the first year of life. On rare occasions, a person may not have the surgery in childhood, if the tetralogy of Fallot was diagnosed or if surgery is not available. These adults may benefit from the surgery. A complete repair is done in several steps, The surgeon patches the hole between the lower chambers of the heart, and repair or replace the pulmonary valve. The surgeon may remove the thickened muscle below the pulmonary valve or extend the smaller of the arteries of the lung.

Temporary surgery, also called temporary repair. Some children with tetralogy of Fallot temporary need of surgery to improve the flow of blood to the lungs while waiting for open heart surgery. This type of treatment is called palliative surgery. A surgeon places a tube called a shunt between a large artery that branches off the aorta and the pulmonary artery. The tube creates a new path for the blood to reach the lungs. This surgery can be done if a baby is born before its time, or if the lung arteries are not fully developed.

The shunt is removed during open-heart surgery to treat tetralogy of Fallot.

Open-heart surgery, called a complete repair. People with tetralogy of Fallot need of open-heart surgery to completely fix the heart.

A complete repair is usually performed in the first year of life. On rare occasions, a person may not have the surgery in childhood, if the tetralogy of Fallot was diagnosed or if surgery is not available. These adults may benefit from the surgery.

A complete repair is done in several steps, The surgeon patches the hole between the lower chambers of the heart, and repair or replace the pulmonary valve. The surgeon may remove the thickened muscle below the pulmonary valve or extend the smaller of the arteries of the lung.

After you complete the repair, the right lower chamber will not have to work as hard to pump blood. As a result, the right of the wall of the chamber must return to their usual level of thickness. The oxygen level in the blood rises. The symptoms tend to improve.

Outlook

The long-term survival rates for people who have had tetralogy of Fallot surgery continue to improve.

People with tetralogy of Fallot need of care for life, preferably a team of health that specializes in diseases of the heart. The examination of health often include imaging tests to see how well your heart is working.. in Addition, tests are carried out to check for complications of the surgery.

Lifestyle and home remedies

After treatment for tetralogy of Fallot, your health care team can suggest some measures to keep the heart healthy. These may include:

  • Sports and activity restrictions. Some people are born with a heart problem, such as the tetralogy of Fallot may have to limit the exercise or sporting activities. But many others may participate in such activities. Ask your or your healthcare team sports and types of activities are safe.
  • Antibiotics to prevent infection in the heart. Sometimes, severe heart problems may increase the risk of infection in the lining of the heart or of the heart valves. This infection is called endocarditis. Antibiotics may be recommended before dental procedures, especially for people who have a mechanical heart valve. Ask your child's healthcare provider if the use of preventive antibiotics are necessary for your child. A good oral care and regular dental checkups are also important ways to help prevent the infection.

Coping and support

You may find that talking with others who have experienced the same situation brings comfort and encouragement. Ask your health care team if there are any support groups in your area.

Living with a congenital heart problem can make some people feel stressed or anxious. Talking with a therapist or school counselor can also help you and your child to learn new ways to manage the stress and anxiety. Your health care team can suggest therapists that may be useful to you or your child.

Preparing for your appointment

Serious congenital heart problems, such as the tetralogy of Fallot is diagnosed during pregnancy or shortly after birth.

If you think your child has a heart problem that was not noticed at birth, talk with your health care team. Be prepared to describe the symptoms of your child. Ask family members if someone was born with a heart problem, it is called a congenital defect of the heart. Some congenital heart defects may occur in families.

Here's some information to help you prepare for your appointment.

What you can do

If you have time to prepare for the medical visit, consider taking these steps.

  • Make a list of your baby's symptoms, including any that seem unrelated to the tetralogy of Fallot.
  • Make a note of you or your child the history of the family, including details on both the mother's and father's family.
  • Note any medications, vitamins or other supplements that are taken during pregnancy, if possible.
  • Ask a family member or friend to come with you, if possible. Sometimes it can be difficult to remember all the information provided to you during an appointment.
  • Write questions for the health care team.

For the tetralogy of Fallot, some basic questions to ask your or your child's doctor include:

  • What is the most likely cause of this condition?
  • There are other possible causes of these symptoms?
  • What kind of tests or does my child need? Do these tests require special preparation?
  • What treatments are available, and which do you recommend?
  • What are the possible complications of this treatment?
  • What is the prognosis after the surgery?
  • Are there any activity restrictions?
  • Will my child be able to play sports? Can my child participate in gym class?
  • Are there brochures or other printed material that I can take my house? What sites do you recommend?

Do not hesitate to ask other questions.

What to expect from your doctor

Usually, there were many questions, such as:

  • When did you first notice the symptoms of your child?
  • Can you describe the symptoms of your child?
  • When do these symptoms occur?
  • The symptoms come and go, or does your child always have?
  • The symptoms seem to get worse?
  • Do you have a family history of congenital heart defects?
  • Is there something that your child's symptoms better?
  • Your child has been growing and the developmental milestones as expected? (Ask your child's pediatrician if you are not sure.)
Symptoms and treatment of the Tetralogy of Fallot