Tetralogy Of Fallot

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Tetralogy Of Fallot

  1. 1. E بسم الله الرحمن الرحيم
  2. 2. , صدق الله العظيم ال ذ اريات 21 بسم الله الرحمن الرحيم
  3. 3. T O F Tetralogy Of Fallot
  4. 4. Historical Review <ul><li>1850 -1911 </li></ul><ul><li>Professor of forensic medicine and hygiene . ,1883 </li></ul>University of Marseille in 1867 . 1888, The &quot; tetralogy of Fallot Thesis of pneumothorax . ,1876
  5. 5. ANATOMY PS OAO VSD RVH
  6. 6. Clinical Diagnosis <ul><li>1-History: </li></ul><ul><li>-Pre-natal Teratogenesis </li></ul><ul><li>-Neonatal cyanosis </li></ul><ul><li>-Recurrent blue spells </li></ul><ul><li>-Similar condition in the family </li></ul><ul><li>2-Symptoms: </li></ul><ul><li>-Cyanosis -Blue spells </li></ul><ul><li>-Dyspnea -Squatting </li></ul>
  7. 7. Clinical Diagnosis (cont.) <ul><li>3-Signs </li></ul><ul><li>*Regional examination </li></ul><ul><li>-Central cyanosis </li></ul><ul><li>-Blue clubbing </li></ul><ul><li>-Growth retardation </li></ul>
  8. 8. Signs (cont.) <ul><li>*Cardiac examination </li></ul><ul><li>I=?Precordial bulge (RVH) </li></ul><ul><li>P=?LP Systolic Thrill (VSD) </li></ul><ul><li>P=Normal sized heart </li></ul><ul><li>A=S1:Normal S2:Single </li></ul><ul><li>No added sounds </li></ul><ul><li>Ejection harsh systolic murmer over PA </li></ul><ul><li>(Severe valvular pulmonary stenosis) </li></ul>
  9. 9. Complications <ul><li>1-Brain insult: </li></ul><ul><li>-Brain anoxia </li></ul><ul><li>-Cerebral thrombosis </li></ul><ul><li>-Brain abscess </li></ul><ul><li>2-SBE </li></ul><ul><li>3-CHF </li></ul>
  10. 10. Investigations <ul><li>I-Laboratory </li></ul><ul><li>1-CBC=Hc% (35%) </li></ul><ul><li>(65%) </li></ul><ul><li>2-ABG=O2% (95%) </li></ul><ul><li>(75%) </li></ul><ul><li>3-S.ferritin(35ng/ml) </li></ul><ul><li>II-Imaging </li></ul><ul><li>1-CXR </li></ul><ul><li>2-ECG </li></ul><ul><li>3-Echo-Doppler </li></ul>
  11. 11. CXR Normal sized Boat-shap Oligemic lung
  12. 12. I III RAD RVH ECG
  13. 13. Echo-Doppler
  14. 14. Treatment <ul><li>I-Medical: </li></ul><ul><li>1-Blue Spells </li></ul><ul><li>2-Prevention </li></ul><ul><li>of complications </li></ul><ul><li>II-Interventions </li></ul><ul><li>1-Palliative </li></ul><ul><li>2-Corrective </li></ul>Blue-spells 1-Position:Knee chest 2-O2 Therapy 3-Morphia,0.2mg/kg IV 4-NaHCO3,3mEq/kg IV 5-Propranolol,0.1-0.2mg/kg IV
  15. 15. Palliative intervention <ul><li>1-Recurrent spells </li></ul><ul><li>2-Hc > 60% </li></ul><ul><li>3-O2 < 75% </li></ul><ul><li>In whom complete correction can not be done </li></ul>Innominate A.  RPA TC PV BV
  16. 16. Surgical corrective operation <ul><li>1-All patients aged 1 year </li></ul><ul><li>2-Average weight 8 Kg </li></ul>

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