ToF including rare disorders and is commonly detected at the time of the newborn. The disorder is always made up of a combination of four series of the following conditions:
- Pulmonary stenosis. It causes the pulmonary valve does not open completely so that the amount of blood reaching the lungs is reduced. Pulmonary valve is a valve that becomes the barrier between the ventricular chamber or chambers of the heart with blood vessels to the lungs.
- Ventricular Septal Defect (VSD). In this disorder, there is a hole formed in the septum or wall that separates the right and left ventricles. It causes mixing of oxygen-rich blood from the left ventricle with oxygen-poor blood from the right ventricle.
- Hypertrophy or abnormal thickening of the muscular wall of the right ventricle. This condition occurs as a result of the narrowing of the pulmonary valve openings.
- Abnormal aortic position, between the left and right ventricles (just above VSD), so that the oxygen-poor blood flows into the aorta participate. In the normal heart, the aorta or a major artery should have been out of the left ventricle which contain oxygen-rich blood.
There are a variety of symptoms ToF. This will vary depending on the severity of the disruption in the blood flow. Some symptoms experienced by patients with ToF include:
- Shortness of breath and rapid breathing (such as wheezing), especially during activity or throughout the meal.
- Skin, lips, and mucous membrane that lines the inner surface of the nose and mouth turn blue (cyanosis) due to low blood circulation in oxygen.
- Basic nail hands and feet are round and convex (clubbing of fingers) due to enlargement of bone or skin around the nail.
- Cranky or fussy.
- Fainting.
- Poor growth.
- Difficulties to gain weight.
- Easily exhausted.
Immediately take your child to a hospital if cyanosis accompanied by grumpy, seizures, fainting, and difficulty breathing. While waiting for the ambulance or on the way to hospital, tilt the child's body and pull your knees toward your chest. This position will help increase blood flow to the lungs.
Causes and Risk Factors Tetralogy of Fallot
The cause behind the Tetralogy of Fallot is not known for certain, but there are a number of factors that may increase the risk to the baby. Some of these risk factors are:
- Maternal age over 40 years.
- Viral infections during pregnancy, such as rubella (German measles).
- Lack of nutrition during pregnancy.
- Having one or both parents with the same disorder.
- Alcoholism during pregnancy.
- Diabetes in the mother.
- Abnormalities at birth that the baby had Down syndrome or DiGeorge Syndrome.
Process Diagnosis Tetralogy of Fallot
Tetralogy of Fallot is generally detected immediately after birth until the age of five. However, based on the severity and symptoms, there is also the ToF only realized when people with already passed through toddlerhood.
The main symptoms of which reference is the skin turned blue. If your baby shows these signs, your doctor may recommend a series of further tests to confirm the diagnosis. The test measures include:
- Blood tests to check blood cell count and hemoglobin.
- Echocardiogram, which checks the performance and structure, thickness and motion in each heartbeat through ultrasound.
- The electrocardiogram (ECG) to check the electrical activity of the heart muscle is abnormal.
- Chest X-rays to check the shape of the heart and the aortic position.
- Cardiac catheterization is used to study the structures of the heart at the same pressure and oxygen levels in the room porch or ventricles of the heart and blood vessels. It is important examinations to ensure their heart defect Tetralogy of Fallot.
- Pulse oximetry, which is a process to measure oxygen levels in the blood.
Handling Step Tetralogy of Fallot
Surgery is the only effective treatment for tetralogy of Fallot. This procedure is generally performed immediately after birth or at the age of a few months. This choice will be determined by the doctor based on your baby's condition.
In general, patients of the surgery aims to widen the blood vessels to the lungs (pulmonary valve) is narrow while closing the hole due to VSD. This operation will help smooth the flow of blood into the lungs, so that oxygen levels in the blood of patients will increase, and the symptoms experienced will be reduced.
However, there are some patients that sometimes requires the installation of a shunt operation (special instrument shaped hose that serves as a bridge) before undergoing major surgical procedure above. Eg in premature infants or those with pulmonary artery that are not fully developed. Shunt will connect the aorta to the pulmonary artery and increases blood flow to the baby's lungs. Shunt will then be released in the next operation.
Diagnosis and operations performed as early as possible will increase the chances of people with ToF to live a normal life. Nevertheless, people still have to undergo a medical checkup to monitor the condition and progress.
Risk of Complications After Surgery
Generally, babies who have undergone surgery can lead a normal life. However, the surgery still has risks lead to complications that include irregular heartbeat or arrhythmia, widening the base of the main artery (aorta), the blood turns back into the right ventricle through the pulmonary valve was leaking, or infection.
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