The aims General aim To become familiar with Tetralogy of Fallot by means of an exposition that also include a case report at the recognition level. Specific aims 1. To identify the definition of Tetralogy of Fallot 2. To describe the most common symptoms, complications and treatment of this illness.
Introduction
Tetralogy of Fallot (TOF) is a congenital Heart defect which is classically understood to involve four anatomical abnormalities. It is the most common cyanotic heart defect, and the most common cause of blue baby syndrome1]
The four components are: Pulmonary stenosis Ventricular Septal Defect Aortic override Right ventricular hypertrophy.
The symptom include : Cyanosis from birth or developing in the first year of life. Heart murmor , difficulty in feeding, failure to gain weight, retarded growth and physical development, dyspnea on exertion, clubbing of the fingers and toes, polycithemia
The ECG shows: right axis deviation, right atrial enlargement, and dominant right ventricular forces over the precordial leads
The chest radiograph typically shows an upturned apex with a concave pulmonary artery segment giving the appearance of a boot-shaped heart.
Corrective operation is advisable at some point for almost all patients with this anomaly Untreated, Tetralogy of Fallot rapidly results in progressive right ventricular hypertrophy due to the increased resistance on the right ventricle. This progresses to heart failure (dilated cardiomyopathy)
Figure 2. Prenatal diagnosis of tetralogy of FallotThe long-axis view of the fetal echocardiogram (A) shows a large ventricular septal defect with over-riding of the aorta. The typical anterocephalad deviation of the outlet septum is seen (B), causing obstruction to the flow into the pulmonary trunk. Image kindly provided by Edgar Jaeggi.
Case report: Andean Perez is a 2 weeks older boy; his mother noticed in the hospital that the boy was ´´blue´´. The mother also refers the boy also had difficulty in feeding, shortness of breath and he wasn’t gain weight correctly She had a normal pregnancy and delivery but she suffers from high blood pressure during her pregnancy. He weight 5.6 pound when he was born His father suffered from HBP. His mother smokes one box of cigarettes daily. On the physical examination we found the patient had cyanosis,retarded growth and physical development, on the examination of the cardiovascular system we found a heart murmur, dyspnea on exertion, clubbing of the fingers and toes, and polycythemia His pulse was 137. His temperature was 37 degrees.
The ex ray revealed an upturned apex with a concave pulmonary artery segment giving the appearance of a boot-shaped heart. The ECG shows right axis deviation, right atrial enlargement, and dominant right ventricular forces over the precordial leads. We considered the patient had Tetralogy of Fallot
Factors that may complicate the treatment of patients with tetralogy of Fallot include infective endocarditis, paradoxic embolism, excessive erythrocytosis, coagulation defects, and cerebral infarction or abscess. Untreated, Tetralogy of Fallot rapidly results in progressive right ventricular hypertrophy due to the increased resistance on the right ventricle. This progresses to heart failure (dilated cardiomyopathy In the differential diagnosis we can consider ventricular septal defects The most recommended treatment for this case is a corrective operation.The prognosis is reserved.
Conclusion Tetralogy of Fallot (TOF) is a congenital heart defect which is classically understood to involve four anatomical abnormalities. It is the most common cyanotic heart defect, and the most common cause of blue baby syndrome