Emergency treatment for cyanosis in Tetralogy of Fallot

Written by Hu Qi Feng
Pediatrics
Updated on September 23, 2024
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During hypoxic attacks of Tetralogy of Fallot, for mild cases, adopting the knee-chest position can provide relief. Severe cases should immediately receive oxygen and be given relevant medication treatment. Normally, attention should be paid to removing factors that cause hypoxic attacks, such as anemia and infections, and keep the child as calm as possible. For cases where hypoxia cannot be effectively controlled through the above measures, emergency surgical repair should be considered.

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Written by Hu Qi Feng
Pediatrics
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Emergency treatment for cyanosis in Tetralogy of Fallot

During hypoxic attacks of Tetralogy of Fallot, for mild cases, adopting the knee-chest position can provide relief. Severe cases should immediately receive oxygen and be given relevant medication treatment. Normally, attention should be paid to removing factors that cause hypoxic attacks, such as anemia and infections, and keep the child as calm as possible. For cases where hypoxia cannot be effectively controlled through the above measures, emergency surgical repair should be considered.

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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 symptoms in infants

Infants with Tetralogy of Fallot often exhibit the following symptoms: First, cyanosis, which is most apparent in areas rich in capillaries such as the lips, fingernail beds, and conjunctiva. Cyanosis tends to worsen gradually during crying, emotional distress, or physical exertion. Second, squatting symptoms; infants who cannot walk often prefer to be held by adults in a flexed position of both lower limbs, reducing venous return and easing the cardiac workload. Older children often exhibit squatting during activities such as walking and playing, frequently squatting down momentarily. Third, infants in a prolonged hypoxic environment may develop clubbing, characterized by the enlargement of the fingertips and toes, with capillary expansion and proliferation, resembling drumsticks. Fourth, episodic hypoxia occurs predominantly in infants, triggered by feeding, crying, or emotional distress, manifesting as episodes of respiratory difficulty, with severe cases leading to sudden fainting or convulsions.

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Written by Hu Qi Feng
Pediatrics
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Tetralogy of Fallot Clinical Characteristics

Tetralogy of Fallot is the most common cyanotic congenital heart disease in infancy, accounting for about 12% of all congenital heart diseases. It is caused by malformations of four heart structures: 1. right ventricular outflow tract obstruction; 2. ventricular septal defect; 3. overriding aorta; 4. right ventricular hypertrophy. Its clinical manifestations may include cyanosis, squatting symptoms, clubbed fingers, and paroxysmal hypoxia attacks. Physical examinations generally show delayed development, a prominent precordial area, and at the second to fourth rib interspace along the left sternal margin, a grade 2 to 3 rough systolic murmur can be heard.

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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.