What position should be adopted when Tetralogy of Fallot is hypoxic?

Written by Hu Qi Feng
Pediatrics
Updated on September 06, 2024
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Treatment of hypoxic episodes in Tetralogy of Fallot: For mild cases, assuming the knee-chest position can alleviate symptoms. Severe cases require immediate oxygen administration and relevant drug therapy. Routinely, it is important to actively eliminate factors that trigger hypoxic episodes, such as anemia and infections, and maintain the child's tranquility. If the above treatments do not effectively control the episodes, emergency surgical intervention for repair or definitive treatment should be considered.

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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 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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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.

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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 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.