Management of Hypoxic Episodes in Children with Tetralogy of Fallot

Written by Hu Qi Feng
Pediatrics
Updated on September 04, 2024
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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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Tetralogy of Fallot surgery success rate

Tetralogy of Fallot is a common cyanotic congenital heart disease in children after the age of one. It consists of four abnormalities: ventricular septal defect, obstruction of the right ventricular outflow tract, overriding aorta, and right ventricular hypertrophy. Once Tetralogy of Fallot is diagnosed, the ultimate treatment is surgical. With the development of pediatric cardiothoracic surgery, there are no specific requirements regarding the birth month or weight of the child for the surgery, so the success rate of Tetralogy of Fallot surgery is now very high. If a child has Tetralogy of Fallot, it is crucial to seek active treatment and not to give up.

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Tetralogy of Fallot syncope causes

The causes of syncope in Tetralogy of Fallot generally involve episodic hypoxia attacks, which are more common in infants. Triggers include breastfeeding, crying, emotional excitement, anemia, and infections. The symptoms manifest as episodic breathing difficulties, and severe cases can suddenly lead to syncope with convulsions or even death. The underlying reason is the narrowing of the pulmonary artery infundibulum accompanied by muscular spasms, causing obstruction of the pulmonary artery and intensifying cerebral hypoxia. Older children may complain of headaches and dizziness.

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Tetralogy of Fallot Emergency Measures

Generally, one should often drink water to prevent infection, prevent dehydration and complications. Infants and young children should be especially careful in their care, to avoid episodes of paroxysmal hypoxia. In mild cases of hypoxic episodes, placing them in a knee-chest position can alleviate the symptoms. In severe cases, oxygen should be administered immediately, along with the appropriate drug treatment. If the episodes cannot be effectively controlled with medication, emergency surgical intervention may be necessary. With the continuous improvement in surgical techniques this year, the mortality rate for curative surgeries has been decreasing.

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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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The most common complication of Tetralogy of Fallot

Tetralogy of Fallot is the most common cyanotic congenital heart disease, consisting of four abnormalities: ventricular septal defect, obstruction of the right ventricular outflow tract, overriding aorta, and right ventricular hypertrophy. Several complications are prone to occur in Tetralogy of Fallot: Firstly, due to the increase in red blood cells, embolism can occur, especially cerebral embolism is the most common. Children over two years old can also develop brain abscesses. Secondly, bacterial endocarditis often occurs at sites such as the right ventricular infundibulum, pulmonary valve, or aortic valve.