What is it?
Having a hole in the ventricular septum results in what?
Mixing of oxygenated and deoxygenated blood.
The Tetrology of Fallot has 4 cardiac problems, name 2.
-Ventricular septal defect
-Overriding aorta
-Pulmonary stenosis
-Right sided ventricular hypertrophy
Which medical imaging diagnostic test is most commonly used to diagnose Tetralogy of Fallot?
Echocardiogram
As a diagnosis is often discovered in early infancy, what is a likely treatment at this age?
A surgery to place a shunt
(helps direct oxygenated blood from aorta to the pulmonary arteries, allowing more oxygenated blood to leave the heart/lungs).
Pulmonary stenosis is the narrowing of the artery that supplies blood from which ventricle? And where does it travel next?
Right ventricle.
To the lungs.
The combination of heart complications results in poor oxygenation and perfusion. What symptoms might you see in a baby/infant?
Cyanotic, blue, pale.
Which diagnostic test measures the electricity of the heart?
ECG
True or False?
The shunt placed in early childhood will be removed later in life when a complete repair surgery is performed.
True.
Directly over the ventricular septum opening.
Name and describe one method of a diagnostic test that may assist in the diagnosis of Tetrology of Fallot
-Echocardiogram (ultrasound images of the heart, can include vascular and doppler flow)
-ECG (measures the electricity of the heart)
-MRI (images of the heart)
-CT (images of the heart)
What are some reasons a patient with TOF may not be able to undergo a cardiac MRI?
Claustrophobia, pacemaker, cochlear implants, prosthetic devices (unremovable), implanted drug infusion devices.
What assessments would you prioritize with a complete repair surgery for a patient with TOF?
Respiratory, cardiovascular, extremities for perfusion.
Additionally asking about level of activity tolerance, food/nutrition intake and tolerance.
Which ventricle is hypertrophic in a patient with TOF?
Right ventricle.
How might this specifically affect infants in terms of development?
Poor feeding, decreased growth, and activity intolerance.
While the echocardiogram and ECG are the top choice for the diagnosis of TOF, what would the other diagnostic images be helpful in identifying?
long-term complications
Fun Fact:
Left untreated, severe regurgitation can lead to long-term damage such as heart failure or permanent ventricular dysfunction. Most adults with TOF will eventually need a valve replacement for regurgitation. This surgery isn't done during childhood because artificial valves don't grow with a child's body.
Close your eyes and spell what TOF stands for!
Tetralogy of Fallot
Why do TOF patients appear blue at the lips and/or fingers?
Due to decreased blood flow to lungs, resulting in decreased oxygenation.
Of the different modalities of medical imaging, which is the best at measuring the right ventricle size and function?
Cardiac MRI
Briefly describe the surgical procedure of placing a shunt for a pediatric patient diagnosed with Tetralogy of Fallot.
One end is sewn to the artery branching off the aorta, the other end is sewn to the pulmonary artery. This creates an additional pathway for blood to travel to the lungs to get oxygen.