The aims General aim To become familiar with Tetralogy of Fallot
by means of an exposition that also include a case report at the
recognition level. Specific aims 1. To identify the definition of
Tetralogy of Fallot 2. To describe the most common symptoms,
complications and treatment of this illness.
Introduction
Tetralogy of Fallot (TOF) is a congenital Heart defect which is
classically understood to involve four anatomical abnormalities.
It is the most common cyanotic heart defect, and the most common
cause of blue baby syndrome1]
The four components are: Pulmonary stenosis Ventricular Septal
Defect Aortic override Right ventricular hypertrophy.
The symptom include : Cyanosis from birth or developing in the
first year of life. Heart murmor , difficulty in feeding, failure
to gain weight, retarded growth and physical development, dyspnea
on exertion, clubbing of the fingers and toes, polycithemia
The ECG shows: right axis deviation, right atrial enlargement,
and dominant right ventricular forces over the precordial
leads
The chest radiograph typically shows an upturned apex with a
concave pulmonary artery segment giving the appearance of a
boot-shaped heart.
Corrective operation is advisable at some point for almost all
patients with this anomaly Untreated, Tetralogy of Fallot rapidly
results in progressive right ventricular hypertrophy due to the
increased resistance on the right ventricle. This progresses to
heart failure (dilated cardiomyopathy)
Figure 2. Prenatal diagnosis of tetralogy of FallotThe
long-axis view of the fetal echocardiogram (A) shows a large
ventricular septal defect with over-riding of the aorta. The
typical anterocephalad deviation of the outlet septum is seen
(B), causing obstruction to the flow into the pulmonary trunk.
Image kindly provided by Edgar Jaeggi.
Case report: Andean Perez is a 2 weeks older boy; his mother
noticed in the hospital that the boy was
´´blue´´. The mother also refers the boy
also had difficulty in feeding, shortness of breath and he
wasn’t gain weight correctly She had a normal pregnancy and
delivery but she suffers from high blood pressure during her
pregnancy. He weight 5.6 pound when he was born His father
suffered from HBP. His mother smokes one box of cigarettes daily.
On the physical examination we found the patient had
cyanosis,retarded growth and physical development, on the
examination of the cardiovascular system we found a heart murmur,
dyspnea on exertion, clubbing of the fingers and toes, and
polycythemia His pulse was 137. His temperature was 37
degrees.
The ex ray revealed an upturned apex with a concave pulmonary
artery segment giving the appearance of a boot-shaped heart. The
ECG shows right axis deviation, right atrial enlargement, and
dominant right ventricular forces over the precordial leads. We
considered the patient had Tetralogy of Fallot
Factors that may complicate the treatment of patients with
tetralogy of Fallot include infective endocarditis, paradoxic
embolism, excessive erythrocytosis, coagulation defects, and
cerebral infarction or abscess. Untreated, Tetralogy of Fallot
rapidly results in progressive right ventricular hypertrophy due
to the increased resistance on the right ventricle. This
progresses to heart failure (dilated cardiomyopathy In the
differential diagnosis we can consider ventricular septal defects
The most recommended treatment for this case is a corrective
operation.The prognosis is reserved.
Conclusion Tetralogy of Fallot (TOF) is a congenital heart defect
which is classically understood to involve four anatomical
abnormalities. It is the most common cyanotic heart defect, and
the most common cause of blue baby syndrome