Lightning Learning: Tetralogy of Fallot

Lightning Learning: Tetralogy of Fallot

“Tetralogy of Fallot is the most common cyanotic congenital heart disease, making up 10% of all CHDs.”
— advice is based on local guidelines & procedures

STOP!

Tetralogy of Fallot is the most common cyanotic congenital heart disease (CHD) and makes up 10% of all CHDs. Consists of a tetrad of defects (see image).

 

Three categories:

  1. Mild (“Pink”) – asymptomatic until age 1-3

  2. Moderate-severe – cyanotic and respiratory distress age
    <1 week

  3. Extreme – cyanotic and respiratory distress <few hours

Risk factors?

  • Male

  • 1st degree FH of CHD

  • Teratogens

  • Genetic conditions

 

LOOK

Hypoxic ‘Tet’ spells…

 

Mild disease:

  • Left ventricular pressure (LVP) > right ventricular pressure (RVP)

  • Acyanotic

Severe disease:

  • Pulmonary Stenosis causes RVP > LVP

  • Cyanosis

Investigations?

ECG: RVH and RAD

CXR: Boot shaped heart

ECHO: Gold standard

Other: e.g. Cardiac MRI

 

LEARN

  • Teach Me Paediatrics: Tetralogy of Fallot
  • Managed with medication and surgery. Definitive repair surgery between 3 months to 4 years. Following surgery >85% survive to adulthood.

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Lightning Learning: Immune Thrombocytopenia (ITP)

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