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Tetralogy of Fallot




Enviado por Sara Garcia



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    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.

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    Introduction

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    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]

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    The four components are: Pulmonary stenosis Ventricular Septal
    Defect Aortic override Right ventricular hypertrophy.

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    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

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    The ECG shows: right axis deviation, right atrial enlargement,
    and dominant right ventricular forces over the precordial
    leads

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    The chest radiograph typically shows an upturned apex with a
    concave pulmonary artery segment giving the appearance of a
    boot-shaped heart.

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    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)

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    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.

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    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.

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    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

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    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.

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    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

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