Tetralogy of Fallot's composition and its causes of formation

Written by Hu Qi Feng
Pediatrics
Updated on September 23, 2024
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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.

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Written by Hu Qi Feng
Pediatrics
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Tetralogy of Fallot in children who prefer squatting is because

Tetralogy of Fallot exhibits squatting symptoms because squatting involves flexing the lower limbs, which reduces the amount of venous return to the heart, thereby decreasing the cardiac workload. At the same time, the arteries of the lower limbs are compressed, increasing systemic vascular resistance, reducing right-to-left shunting, and temporarily alleviating hypoxia symptoms. Infants who cannot walk often prefer to be held with their thighs up, with both lower limbs bent; after they become able to walk, they frequently squat down momentarily during walking or playing.

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Written by Hu Qi Feng
Pediatrics
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Tetralogy of Fallot seizure causes

The cause of seizures in Tetralogy of Fallot is episodic hypoxia leading to cerebral hypoxia, which causes seizures, commonly seen in infants. These seizures can be triggered by feeding, crying, emotional excitement, anemia, or infections, manifesting as episodic breathing difficulties. In severe cases, sudden fainting, convulsions, or even death may occur. The underlying cause is the narrowing of the pulmonary artery infundibulum and sudden muscle spasms, which lead to temporary pulmonary artery obstruction, worsening cerebral hypoxia.

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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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Management of Hypoxic Episodes in Children with Tetralogy of Fallot

In the treatment of hypoxic episodes in children with Tetralogy of Fallot, mild cases can be alleviated by positioning the child in a knee-chest position, while severe cases should receive immediate oxygen therapy, along with appropriate medication to correct acidosis. It is important to regularly eliminate factors that may trigger hypoxic episodes, such as anemia and infections, and to maintain a calm environment for the child. If these measures do not effectively control the episodes, emergency surgical repair should be considered.

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Written by Yan Xin Liang
Pediatrics
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The main cause of hypoxic attacks in Tetralogy of Fallot

Tetralogy of Fallot is a complex congenital heart disease, characterized by ventricular septal defect, right ventricular outflow tract obstruction, aorta overriding, and right ventricular hypertrophy. When the obstruction of the right ventricular outflow tract is severe, pulmonary artery blood flow significantly decreases. A large amount of unoxygenated venous blood passes through the ventricular septal defect causing a right-to-left shunt, which clinically manifests as severe cyanosis and increased red blood cells, and different degrees of hypoxia in the systemic circulation. Factors that can induce hypoxic episodes in these infants include feeding, crying, emotional agitation, anemia, infection, etc. These can suddenly lead to fainting, convulsions, or even death. The main reason is generally due to a sudden muscle spasm at the narrow pulmonary artery infundibulum on top of pre-existing stenosis, causing temporary pulmonary artery obstruction and exacerbating cerebral hypoxia, thus leading to severe hypoxic attacks.