Tetralogy of Fallot (TOF) is an uncommon congenital heart defect related to newborn babies. The condition occurs in children from birth and affects the whole functioning of the heart and body. As a consequence it made difficulties for infant’s heart to supply oxygen-rich blood to other body organs, due to cardiac abnormalities present in the arteries.
The babies with TOF might have gray or blue skin colors because of low oxygen levels. Tetralogy of Fallot is diagnosed during pregnancy or even after the birth. Children diagnosed with TOF need surgery treatment in order to fix this heart-health problem and to restore normal blood flow in the body within a year.
Complications with TOF
A baby born with this condition has four abnormalities in the heart that are mentioned below:
- Ventricular Septal Defect (VSD)- It is a hole complexity found in the wall which separates the heart’s lower chambers ventricles, allowing blood to mix between the two chambers.
- Pulmonary Stenosis- In this abnormality the pulmonary valve and main pulmonary artery are not wide enough, hence it doesn’t get enough blood through to the lungs with heartbeat.
- Overriding Aorta- This is a condition when the aorta, the main blood vessel that carries oxygen-rich blood to the body, is shifted over ventricles instead of being above the left ventricle.
- Right Ventricular Hypertrophy- The right ventricle is responsible for pumping blood to the lungs however, it gets enlarged because of workload and disturb the whole heart functioning.
Causes of TOF
The exact causes of developing TOF in children are not known however, possible reasons for the condition are as follows:
- DNA Changes– If a parent has heart issues it normally does not pass on to the children however, the risk of occurrence remains, when the both parents have heart problems. Hence the condition often develops in children through DNA and sometimes DNA may be changed due to any other reason.
- Alcohol Consumption- When an expecting lady has rubella or diabetes then it poses a high risk of developing congenital heart problems in a child. Other than that, drinking alcohol and eating an improper diet during pregnancy also put the fetus at a risk of causing TOF condition.
- Late pregnancy– Late pregnancy also contributes to cardiac abnormalities in a baby. When a woman expects after 40 could be a risk of TOF.
- Phenylketonuria- It is a rare metabolic disorder that releases an excessive amino acid and becomes a reason for developing TOF in a child.
Symptoms of Tetralogy of Fallot
Following are the signs and symptoms that shows, a baby has TOF defect in the heart:
- Being Restless
- Gray blue skin color
- Being unconscious
- Shortness in breathing
- Feeling tired
- Weak limbs
- lack of appetite
- heart palpitation
- Fainting
- Regular long episodes of crying
- Feeling trouble while sleep
How to Diagnose TOF?
Following tests are conducted to Diagnose TOF conditions in a child. Through these tests a doctor gets to know the structure of the heart. Theses dianoetic tests are as follows:
- Prenatal Test– Within 18 to 22 weeks of pregnancy a doctor conducts a fetal echocardiogram or ultrasound test to see and hear the baby’s heartbeat. Through this a health care professional gets to know the normal or abnormal structure of the heart.
- Pulse Oximetry– Pulse Oximeter is a small device that detects the oxygen level of the heart. Once the baby is born a healthcare provider does pulse oximetry test to check the abnormalities with the baby’s heart.
- Echocardiogram- This diagnosis test is performed to know the heart functioning and shape of the heart through sound waves.
- Chest X-rays or CT scans– Through CT scans and chest X-rays a doctor identifies the clear images of the heart and recognizes the malfunctioning present in the heart arteries that is restricting blood flow.
Treatment Procedure for Tetralogy of Fallot in India
A surgery is a primary treatment option used for the TOF patients. Through surgical procedure doctors correct the underlying cardiac complexity and restore normal blood flow into the heart.
Surgery procedure
Preoperative Assessment of the Patient- A complete evaluation is done on the patient to check his overall condition before the surgery treatment. This includes echocardiogram, cardiac catheterization, blood tests, X-ray and CT scans.
Anesthesia and Incision– A children cardiac surgeon performs the surgery first he gives anesthesia to the patient in order to make him sleep. Then incisions are created in the chest through certain medical instruments that help to operate the heart surgery.
Cardiopulmonary Bypass– Doctors attach the patient to a heart-lung bypass machine for a short period of time that takes over the function of the heart and lung and gives support throughout the procedure. The machine ensures blood circulation and oxygenation when the surgeon is operating on the heart.
Surgical Repair– While operating on the heart a surgeon focuses on the ventricular septal defects through patching or closing the hole, removes the pulmonary stenosis and repositions the aorta on its correct location. However, all the specific surgical approaches depend on the abnormalities present in the heart.
Post Surgical Care- After the surgery the patient’s condition is closely monitored in the ICU and different medicines are administered in order to manage pain, discomfort, infection and cardiac support. In addition, follow-up is also crucial for monitoring the recovery and heart function.
Prevention of TOF
Here are some certain steps that can prevent the risk of causing Tetralogy of Fallot, these are as follows:
- If you have Phenylketonuria condition do not eat protein rich foods during pregnancy.
- Regularly measure diabetes level.
- Get rubella vaccine and avoid smoking, drinking and tobacco.
- Avoid having anxiety or depression medications.
- Do walk for an half hour on a regular basis and get sunlight.
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