One of the congenital defects of the heart, often present in children is tetralogy of Fallot. Tetralogy of Fallot is diagnosed soon after birth or in early infancy by healthcare professionals like General Physician in New Garden Town Lahore.
Most children do well after treatment but need regular follow-up with heart specialists.
What is tetralogy of Fallot (TOF)?
Tetralogy of Fallot occurs during the period of fetal growth. There are four abnormalities in tetralogy of Fallot, including:
- Stenosis or narrowing of pulmonary valve: the pulmonary artery is the main blood vessel that takes the blood from the right chamber of the heart to the lung for oxygenation. Narrowing of the valve in the pulmonary artery—pulmonary valve stenosis reduces the blood flow to the lungs.
- Right ventricular hypertrophy: when the pulmonic valve is blocked, the right ventricle has to work extra hard to pump the blood into the lungs. This causes hypertrophy of the right ventricle and in turn decreases the capacity of the ventricle. Over time, this causes the heart muscle to stiffen and eventually fail.
- Overriding aorta: in tetralogy of Fallot, the aorta is shifted to the right, and branches of the left ventricle, instead of the normal left position.
- Ventricular septal defect: this is a hole in the wall or septum between the two ventricles of the heart, causing the oxygenated and de-oxygenated blood to mix. The amount of oxygenated blood reaching the body is greatly reduced as a result and eventually weakens the heart.
What is the effect of tetralogy of Fallot on the baby?
As a consequence of the tetralogy of Fallot, the amount of oxygenated blood reaching the body is greatly reduced. The heart has to work extra hard and even mild activity can cause cyanosis—a bluish tint to the skin and lips of the baby. Due to the spells of cyanosis, the baby can also faint, or have seizures as the blood supply to the brain is compromised.
As the baby grows older, the deoxygenation gets worse, and the extra work by the heart causes the heart to have irregular beats or even heart failure. In babies with tetralogy of Fallot, the risk of endocarditis is also higher.
The irregular heartbeat and the turbulent blood flow causes “heart murmurs”. The baby also becomes increasingly fussy if the defect is not surgically corrected. There is also breathing difficulty in the baby, along with rapid heartbeat (palpitations) and clubbing.
What are the causes of tetralogy of Fallot?
Tetralogy of Fallot is a consequence of a number of viral illnesses, unknown factors, and environmental factors during pregnancy. The common causes include alcoholism in the mother during pregnancy, the presence of concurrent Down syndrome or DiGeorge syndrome in the baby, and poor nutrition of the mother during pregnancy. Additionally, babies of mothers who suffer viral illnesses such as rubella are also predisposed to the tetralogy of Fallot. The risk is also greater if one or both the parents have TOF, and if the mother is older than 40 years of age.
How is tetralogy of Fallot diagnosed?
Tetralogy of Fallot is diagnosed through investigations like:
● a pulse oximeter, which senses how much oxygen is there in the blood
● chest x-ray
● electrocardiogram, which records the electrical activity of the heart and detects arrhythmias
● cardiac catheterization, which is a flexible tube inserted into the heart to provide information about the heart
How is tetralogy of Fallot treated?
Tetralogy of Fallot needs evaluation by professionals like General Physician in DHA Phase 5 Karachi. In most cases, children are referred to pediatric surgeons for the repair of defects. There are two kinds of surgeries for TOF. In complete repair, the surgeon repairs the ventricular septal defect, the overriding aorta as well as the stenotic valve. In very small babies palliative surgery or temporary repair is done to improve the blood flow to the lungs.