The main cause of hypoxic attacks in Tetralogy of Fallot

Written by Yan Xin Liang
Pediatrics
Updated on February 02, 2025
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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.

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Written by Yan Xin Liang
Pediatrics
1min 11sec home-news-image

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.

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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 Chen Guang Yin
Cardiology
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Can someone with Tetralogy of Fallot have a second child?

Tetralogy of Fallot is a congenital cardiac defect that has not been found to have a definite genetic relationship, meaning no chromosomal abnormalities have been discovered. However, congenital heart disease does tend to occur within families to a certain extent, indicating some level of familial predisposition. The primary cause, however, is believed to be related to viral infections during the first three months of pregnancy or the use of certain medications. Therefore, we believe that parents of a child with Tetralogy of Fallot can consider having a second child.

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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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Is tetralogy of Fallot a chromosomal problem?

Tetralogy of Fallot is the most common cyanotic congenital heart disease in childhood, consisting of four defects: ventricular septal defect, obstruction of the right ventricular outflow tract, overriding aorta, and right ventricular hypertrophy. It is a type of congenital heart disease, which generally stems from abnormal cardiovascular development during fetal life, resulting in cardiovascular malformations not controlled by chromosomes. The malformation of the cardiovascular system is mainly caused by genetic factors, environmental factors, and their interactions. The exact cause of this congenital heart disease has not been fully identified yet, indicating that it is not a chromosomal disease but a result of cardiovascular developmental abnormalities during fetal life.