TETRALOGY OF FALLOT, PARENT TEACHINGPresentation Transcript
The heart works as a pump that keeps the blood flowing.
The heart is divided into 4 chambers, two filling chambers and two pumping chambers.
The veins drain the blood into the heart. The arteries carry blood away from the heart
The chambers and vessels are separated by valves that control the blood flow. A wall of muscle separates the left and right side of the heart.
The red blood carries oxygen around the body.
The blue blood is returned to the right side of the heart, and into the lungs for more oxygen.
The blood then flows into the left side of the heart and is pumped around the body again.
There are four major defects in Tetralogy of Fallot.
A ventricular septal defect (a hole between the ventricles) and many levels of obstruction from the right ventricle to the lungs ( pulmonary stenosis ) are the most important. Also, the aorta (major artery from the heart to the body) lies directly over the ventricular septal defect , and the right ventricle develops thickened muscle .
Ventricular Septal Defect or a "hole in the heart". This is a hole in the muscle between the left and right pumping chambers (ventricles).
Narrowing of the artery from the right pumping chamber in the heart to the lungs. (pulmonary artery)
The right ventricle (pumping chamber) muscle increases in amount, from working at high pressure.
The large artery (aorta) lies over the top of the "hole in the heart".
Some of the blue blood from the right side of the heart flows through the hole to the aorta.
It does not go to the lungs for oxygen.
This blood with little oxygen is pumped into the aorta and around the body.
4. OVERRIDING OF AORTA.
Tetralogy of Fallot occurs during fetal growth, when the baby's heart is developing. While factors such as poor maternal nutrition, viral illness or genetic disorders may increase the risk of this condition, in the majority of cases the cause is unknown.
While the exact cause of tetralogy of Fallot is unknown, several factors may increase the risk of a baby being born with this condition. These include:
A virus illness of the mother, such as rubella (measles), during pregnancy
A mother older than 40
A parent who had tetralogy of Fallot
Children born with Down syndrome, a genetic condition resulting from an extra 21st chromosome, are also at increased risk of having tetralogy of Fallot
Signs and symptoms of tetralogy of Fallot vary, depending on the extent of obstruction of blood flow out of the right ventricle and into the lungs. Typical signs and symptoms may include:
A bluish coloration of the skin caused by blood low in oxygen (cyanosis)
Shortness of breath and rapid breathing
Loss of consciousness (fainting)
Clubbing of fingers and toes (an abnormal, rounded shape of the nail bed)
Lack of appetite & Poor weight gain
Tiring easily during play
Babies with tetralogy of Fallot will suddenly develop deep blue skin, nails and lips after crying, feeding or upon awakening. These episodes are called "Tet spells" and result from a rapid drop in the amount of oxygen in the blood.
Toddlers or older children may instinctively squat when they are short of breath. Squatting increases blood flow to the lungs.
Seek medical help if you notice that your baby has the following symptoms:
Bluish discoloration of the skin
Passing out or seizures
If your baby becomes blue (cyanotic), immediately place your child on his or her side and pull the knees up to the chest. This helps increase blood flow to the lungs.
Small, frequent meals may be easier for your baby to handle
A supplement or an extra feeding can give the baby more calories, vitamins, or iron
Lowering your baby's anxiety or stress can help prevent "tet spells" and save the baby's energy.
Bring the baby's or child's knees up tight against his or her chest (this is called the knee–chest position) or have your child squat down. This will increase blood flow to the lungs
Some children with tetralogy of Fallot may need to limit certain types of exercise/activities
All babies with tetralogy of Fallot need corrective surgery. Without treatment, your baby may not grow and develop properly. He or she is also at increased risk of serious complications, such as infective endocarditis, an inflammation of the inner lining of the heart caused by a bacterial infection, or stroke, a blood clot in the brain.
Unfortunately, untreated cases of tetralogy of Fallot usually develop severe complications over time, which may result in death or disability by early adulthood
Surgical Treatment Tetralogy of Fallot is treated surgically. A temporary operation may be done at first if the baby is small. Complete repair comes later. Sometimes, the first operation is a complete intracardiac repair.
Temporary Operation In small and very blue infants, a shunt operation may be done first to provide adequate blood flow to the lungs. This lets the baby grow big enough to have a full repair. The shunt is built between the aorta and the pulmonary artery. The shunt is removed when a complete intracardiac repair is done later.
Complete Repair Complete repair tends to be done early in life. Once it was more common to do a temporary operation first and a complete repair later in childhood.
To do a complete repair, the surgeon closes the ventricular septal defect with a patch and opens the right ventricular outflow tract by removing some thickened muscle below the pulmonary valve, repairing or removing the pulmonary valve and enlarging the peripheral pulmonary arteries that go to both lungs. Sometimes a tube is placed between the right ventricle and the pulmonary artery. This is sometimes called a Rastelli repair.
After surgery your baby will require continuing care.
routine check-ups to make sure that the procedure was successful and to monitor for any new problems.
limit physical activity
take antibiotics during dental procedures to prevent infections.
While there's no known prevention for tetralogy of Fallot, it's important to follow your doctor's advice about taking care of yourself during pregnancy.
Following a balanced diet and abstaining from alcohol and tobacco will increase the chances that your baby will be born healthy.