Tetralogy of Fallot

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Written by Chen Guang Yin
Cardiology
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Does Tetralogy of Fallot involve chromosomal abnormalities?

Tetralogy of Fallot is primarily a developmental disorder, generally unrelated to chromosomes, with no chromosomal abnormalities. The cause of the disease is still not very clear. If pregnant again and giving birth again, it generally does not recur. Therefore, couples undergoing chromosomal testing before pregnancy is a common practice. It is generally believed that the four malformations in Tetralogy of Fallot occur due to viral infections acquired by the fetus during pregnancy, the mother consuming alcohol, or the use of certain medications during pregnancy. Currently, these are considered related factors, and so far, no abnormalities have been found related to genetics or chromosomes.

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Written by Yao Li Qin
Pediatrics
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Can Tetralogy of Fallot be cured?

Tetralogy of Fallot is a type of congenital heart disease linked to family genetics and is considered quite severe among congenital heart conditions. Generally, within a few months after birth, children will exhibit cyanosis of the skin. It is crucial to perform surgery on the child promptly in such cases. Currently, the level of pediatric cardiothoracic surgery in our country has developed very rapidly. For typical cases of Tetralogy of Fallot, surgical treatment can be curative. Moreover, there are no specific requirements regarding weight and age for children undergoing heart surgery nowadays. Therefore, once Tetralogy of Fallot is diagnosed in young children, it is best to perform surgery as soon as possible. These children can then grow up, develop normally, and attend school like their peers.

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Written by Yao Li Qin
Pediatrics
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Can children with Tetralogy of Fallot be desired?

Tetralogy of Fallot is a relatively severe congenital heart disease. If it is detected during the fetal period, it is not an indication for termination of pregnancy. In other words, one should not choose to not have the baby simply because it has Tetralogy of Fallot. However, it is crucial that the baby undergoes a timely echocardiogram after birth to assess the condition and undergo surgery as soon as possible. Currently, pediatric surgery, particularly cardiothoracic surgery, is developing very rapidly in our country. With multiple surgeries, Tetralogy of Fallot can be surgically cured. Therefore, having a child with Tetralogy of Fallot is not an indication for termination of pregnancy.

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Written by Yao Li Qin
Pediatrics
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Tetralogy of Fallot electrocardiogram manifestations

Tetralogy of Fallot is a common type of cyanotic congenital heart disease, primarily composed of four structural components: first, a ventricular septal defect; second, an overriding aorta; third, hypertrophy of the right ventricle; and fourth, obstruction of the right ventricular outflow tract. When performing an electrocardiogram (ECG) on Tetralogy of Fallot, it often shows right ventricular hypertrophy, and can also display right atrial hypertrophy. Initially, there may be hypertrophy of both the left and right ventricles. As the child develops cyanosis, it progressively evolves into hypertrophy of the right ventricle. These are the typical ECG findings in Tetralogy of Fallot.

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Written by Hu Qi Feng
Pediatrics
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Can Tetralogy of Fallot be cured?

With the continuous improvement of surgical techniques, the cure rate for total corrective surgery for Tetralogy of Fallot is increasing, and the mortality rate is continuously decreasing. Mild cases may have the opportunity to undergo a one-stage corrective surgery between the ages of five and nine. However, for patients with significant clinical symptoms, palliative surgery should be performed within six months after birth. Once the general condition improves and pulmonary vasculature develops, they can proceed with the corrective surgery. Overall, the cure rate for Tetralogy of Fallot is continuously improving.

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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.

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Written by Hu Qi Feng
Pediatrics
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Tetralogy of Fallot cyanosis cause

Tetralogy of Fallot, due to a ventricular septal defect combined with right ventricular outflow tract narrowing, can display left-to-right, bidirectional, or even right-to-left shunting at the ventricular level. Patients with mild pulmonary stenosis can have left-to-right shunting and usually do not exhibit cyanosis. However, when the pulmonary stenosis is severe, significant right-to-left shunting occurs, and clinically apparent cyanosis becomes evident. Cyanosis is commonly observed in areas rich in capillaries and superficial tissues, such as the lips, fingertips, nail beds, and bulbar conjunctiva.

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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 Hu Qi Feng
Pediatrics
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The reason for squatting in Tetralogy of Fallot

The reason for squatting is that when squatting, the lower limbs are bent, which reduces the amount of blood returning to the heart through the veins, thereby reducing the load on the heart. At the same time, the arteries in the lower limbs are compressed, which increases the resistance in the systemic circulation and reduces the right-to-left shunt volume, allowing temporary relief from hypoxia symptoms. Babies who cannot walk often like to be held by adults in a position that bends the lower limbs to reduce the amount of blood returning to the heart. This frequently occurs during walking and playing, often characterized by brief periods of squatting.

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Written by Hu Qi Feng
Pediatrics
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Tetralogy of Fallot's composition and its causes of formation

Tetralogy of Fallot consists of four abnormalities. First, there is a narrowing at the right ventricular outflow, ranging from the entrance of the right ventricular infundibulum to the branches of the left and right pulmonary arteries. Second, there is a ventricular septal defect, characterized by a deficiency around the membranous part that extends towards the outflow. Third, the aorta overrides, where the base of the aorta is enlarged and rotates clockwise to the right, straddling the septal defect. Fourth, right ventricular hypertrophy, which is a secondary lesion.