TETRALOGY OF FALLOT(TOF)

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Tetralogy of fallot is simply a heart disease(congenital heart disease) condition that involves four other different heart conditions

• VSD(ventricular septal defect): This is a condition that is simply characterized a hole in the lower chambers of the heart(ventricules).

• Pulmonary stenosis:this is a condition that involves narrowing of the route of the right ventricule,(right ventricular output tract(RVOT))

• Right ventricular hypertrophy: These involves the thickening of the muscles of the right ventricle.

• Overriding aorta: These allows blood from the lower chambers(ventricles) to perfuse into the aorta.

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CAUSE
TOF is usually present at birth. The main cause remains unknown, but it is usually seen in kids with down syndrome or digeorge syndrome. Genetic factors can also be held responsible.
Risk factor: can be things the fetus came in contact with or things the mother came in contact with, such as drugs.

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IT'S EFFECTS ON THE HEART
In a normal heart the left part of the heart pumps blood to other parts of the body while the right pumps blood to the lungs(pulmonary circulation). But due to the VSD(hole in the ventricles) blood from the right ventricle which is de-oxygenated(blue blood) enters the left ventricle and is being pumped to the whole body.

The amount of blood pumped to the lungs is also reduced due to pulmonary stenosis(narrowing of the RVOT).Since the path at which blood passes from the heart to the lungs is narrowed, blood reaching the lungs for oxygenation is thereby reduced.

SYMPTOMS

• Bluish colour of the skin
• fingers becomes clubbed
• Heart murmur or cyanosis
• difficulty in breathing
• fainting
• seizures

OTHERS

• Arrhythmia(irregular Heart rates)
• Endocarditis: These refers to increased risk of infection of the layers of the heart.
• Growth and development is also reduced
• right-to-left shunt: These is simply blood without oxygen.

DIAGNOSIS
DURING PREGNANCY
TOF might be seen during ultrasound( these creates pictures of the baby) These findings might warrant a foetal echocardiography if a TOF is suspected.
A foetal echocardiography is an ultrasound the test specifically for the heart of the foetus. These tests can then confirm the diagnosis. The echocardiogram produces pictures of the Heart.

AFTER BIRTH
A child with TOF is usually diagnosed after "a tet spell" has been observed (child turning blue while feeding or crying).
The presence of other symptoms as outlined above can warrant the physician to query a TOF, which is then confirmed with Heart tests such as simple pulse oximetry, electrocardiography and ultimately echocardiography.

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TREATMENT
These condition can be remedied by surgical intervention after the baby is born.
During these surgery, the surgeons:

• widen or change the pulmonary leaflet.
• enlarge the passage to the artery leading to the lungs (pulmonary artery)
• patch the ventricular septal wall (the hole) between the two ventricles.

After surgery these patients will need to have follow ups by a cardiologist, inotherwords, they need to see a cardiologist from time to time to curb any possible complications if any results. Generally most live an active normal life.

STATISTICS
Normally statistics shows that the life expectancy of a TOF child is very low, especially as they grow up.
With

• 66% living up to 1year of age
• 49% to 3years of age
• 24% to 10 years of age
  After which instant death can come at anytime.

Shalom...
I am Apeximomen.