This is from the low oxygen levels in their blood. Genes and family history may play a part in TOF. It may also be caused by Down syndrome or 22q Most of the time, this heart defect occurs by chance, with no cause.
Symptoms can show up a bit differently in each child. The most common symptom is a bluish color of the skin, lips, and nail beds.
This may come on in sudden spells, called TET spells. It happens when blood oxygen level drops quickly. During the spell, babies may have a hard time breathing.
They may also be tired and fussy. In the most severe cases, they may lose consciousness. The symptoms of TOF may be similar to symptoms caused by other problems. Make sure that your child sees a healthcare provider for a diagnosis. Your child will need to see a heart doctor cardiologist. They will check your baby and listen to their heart and lungs. Tests may be done to confirm the diagnosis. This test records the electrical activity of the heart.
It also shows abnormal rhythms arrhythmias or dysrhythmias and spots heart muscle stress. These issues may be caused by TOF.
An echo uses sound waves to make a moving picture of the heart and heart valves. This test may show structural changes caused by TOF. A cardiac catheterization gives detailed information about the structures inside the heart. They will inject your child with contrast dye to see their heart more clearly. It also measures blood pressure and oxygen in the pulmonary artery and aorta. Talk with your doctor about whether this is necessary.
If you want to be physically active, ask your doctor what would be a safe activity for you. Take any medication your doctor prescribes as necessary.
If you start to take any other medications or supplements, let your doctor know so you can avoid any adverse interactions or effects.
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Learn about the symptoms, causes, and treatment. Health Conditions Discover Plan Connect. Surgical correction of the defect is always necessary.
Occasionally, patients will require a surgical palliative procedure prior to the final correction. Corrective repair of tetralogy of Fallot involves closure of the ventricular septal defect with a synthetic Dacron patch so that the blood can flow normally from the left ventricle to the aorta.
The narrowing of the pulmonary valve and right ventricular outflow tract is then augmented enlarged by a combination of cutting away resecting obstructive muscle tissue in the right ventricle and by enlarging the outflow pathway with a patch.
In some babies, however, the coronary arteries will branch across the right ventricular outflow tract where the patch would normally be placed. In these babies an incision in this area to place the patch would damage the coronary artery so this cannot safely be done. When this occurs, a hole is made in the front surface of the right ventricle avoiding the coronary artery and a conduit tube is sewn from the right ventricle to the bifurcation of the pulmonary arteries to provide unobstructed blood flow from the right ventricle to the lungs.
Survival of children with tetralogy of Fallot has improved dramatically over recent decades. In the absence of confounding risk factors, more than 95 percent of infants with tetralogy of Fallot successfully undergo surgery in the first year of life. Surgical repair is more difficult when the pulmonary arteries are critically small or when the lung blood flow is supplied predominantly by aortopulmonary collaterals.
Most babies are fairly sick in the first few days after surgery, since the right ventricle is "stiff" from the previous hypertrophy thickness and because an incision is made into the muscle of the ventricle, making the muscle temporarily weaker.
This right ventricular dysfunction usually improves significantly in the days following surgery. Patients may also have rhythm problems after surgery. An abnormally fast rhythm called junctional tachycardia may occur and may require treatment with medication or the use of a temporary pacemaker.
This abnormal rhythm is usually temporary and the rhythm generally will return to normal as the right ventricle recovers. Patients are also at risk for slow heart rates after surgery due to heart block. Heart block may be caused by injury to or inflammation of the conduction system in the heart. In many patients, the conduction improves and normal rhythm returns.
Rarely, a permanent pacemaker may be necessary. Since a normal circulation is produced by the tetralogy of Fallot repair procedure, long-term cardiac function is usually excellent.
However, the repair does usually leave the child with a leaky insufficient pulmonary valve. In this situation, after the right ventricle pumps blood out to the pulmonary arteries, some of the blood will flow back into the right ventricle. This creates extra volume in the right ventricle forcing it to work harder and become dilated. In a small percentage of children, this pulmonary insufficiency can lead to diminished function of the right ventricle. Symptoms of fatigue, especially with exercise, may develop.
In these cases, replacement of the pulmonary valve is often recommended. Patients who have had repair of tetralogy of Fallot can also redevelop a narrowing at the outflow area or in the branch left or right pulmonary arteries, which will cause the right ventricle to pump at abnormally high pressures.
If these problems occur, surgical intervention to further widen the outflow tract or pulmonary arteries may be necessary.
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