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Tetralogy of Fallot is a rare condition caused by a combination of four heart defects which are present at birth.
These errors affect the structure of the heart, causing an impediment the flow of oxygen to the heart and the rest of the body. Infants and children who have suffered from tetralogy of Fallot usually have a slightly blue tint to the skin, because their blood does not carry enough oxygen.
Tetralogy of Fallot is the most frequently diagnosed in infancy or soon after, but there are cases where the disease comes become apparent until in later years, depending on the severity of symptoms and damage caused by the disease.
Early diagnosis and timely surgical treatment allow the patient to live relatively healthy, but it is necessary to constant medical supervision and limitations.
The symptoms of tetralogy of Fallot
Tetralogy of Fallot doing a variety of symptoms, depending on the extent to which blood flow is blocked from the right ventricle to the lungs. Most, however, symptoms include:
- bluish discoloration of the skin caused by a deficiency of oxygen in the blood (cyanosis)
- shortness of breath and rapid breathing, especially while eating and exercise,
- loss of consciousness, fainting,
- unusual, rounding bearing nails in the fingers and toes,
- a poor weight gain,
- a weak strength and susceptibility to fatigue during games and activities,
- background noise heart.
There are also cases in which patients with tetralogy of Fallot, there is a dark blue color of the skin around the nails and mouth, particularly after prolonged crying, screaming, or after eating. These conditions are associated with a rapid decrease of oxygen in the blood and are most common in babies from 2 to 4 months. Older children very often have shortness of breath.
Symptoms that should arouse concern are:
- breathing difficulties,
- bluish discoloration of the skin,
- convulsions or tremors,
- general weakness,
- excessive irritability.
Cyanosis is a life-threatening condition, which is why, as soon as possible, restore the patient blood flow in the lungs.
Tetralogy of Fallot occurs already during fetal development, at a time when is developing baby’s heart. When the mother eats poorly, suffer from the viral disease or genetic disorder, may increase the risk of illness. In most cases, however, causes of tetralogy of Fallot are not known.
Tetralogy of Fallot consists of four developmental abnormalities of heart:
- pulmonary valve stenosis – narrowing of the pulmonary valve,
- pulmonary valve stenosis that reduced blood flow to the lungs, but can also affect the muscles below the pulmonary valve,
- ventricular septal defect – a septal defect that impairs the flow of oxygen-rich blood to the lungs, which in turn reduces the oxygen supply to the whole body, and may weaken the heart,
- displacement of the aorta – the main artery is conducting blood that is not working sufficiently efficiently.
As a result of the overworking heart can occur the right ventricular hypertrophy. Over time, it makes the wall of the right ventricle stiff, and becomes weaker and eventually ceases to function.
However, there are cases of the disease, in which the children also have other heart defects such as a hole between the upper chambers of the heart or ventricular septal defect.
Risk factors that increase the probability of tetralogy of Fallot are:
- viral disease during pregnancy – rubella,
- alcoholism mothers during pregnancy,
- poor nutrition during pregnancy,
- maternal age at pregnancy (over 40 years)
- tetralogy of Fallot ascertained in the parent,
- the presence of Down syndrome or DiGeorge syndrome.
In children with tetralogy of Fallot, there is a high risk of complications such as endocarditis – infection of the inner lining of the heart valves or due to a bacterial infection.
Untreated disease may lead to disability and even death.
Diagnosis of illness usually occurs after birth, as a child with tetralogy of Fallot, has a bluish skin tone, or heart murmurs. The tests may include the echocardiography, electrocardiogram, chest x-ray, measurement of the level of oxygen and cardiac catheterization.
The most common treatment is focused on the operating procedure, which allows fixing at least some of these problems. Is used intra-cardiac repair – open-heart surgery, which takes place during the first year of life. It has the task of putting the patches on septal defects or focused on the repair of the pulmonary valve stenosis and enlargement of the pulmonary arteries so that they can increase the flow of oxygen-rich blood to the lungs. This operation can significantly improve the health of the baby.
Another method of treatment is temporary surgery, used most often in children born prematurely, or in those poorly developed. The surgeon creates here, bypass valve, which branches off from the aorta and pulmonary artery. This method allows increasing the flow of blood to the lungs to help the child gain the willingness to proper operation.
Surgery may carry a lot of complications, but most often highly improves the quality of life of the patient. It is necessary, however, constant medical care and some lifestyle changes.