As you know, there are blue and white congenital heart defects of children, tetralogy of Fallot - from the first. This is a congenital anomaly that requires observation of doctors and planned treatment. With timely care, you can bring your health to normal.
Features of the disease
Heart pathology caused by a set of four disorders:
- Venous blood flow through the natural canals of the right half is difficult due to one of the variants of stenosis:
- of the pulmonary trunk,
- valve,
- in the branches of the pulmonary artery,
- various combinations of the listed disorders.
- Deviation from the correct location of the aorta, which leads to a situation where blood from both ventricles enters it.
- Pathological disorder in the structure of the septum between the ventricles.
- Because of the difficult exit of blood from the ventricle of the right side, it is susceptible to destructive changes.
Disease is a type of heart disease. Represents a congenital anomaly. Each of the four breakdowns in the structure of the heart, has a wide variety of options, as in a specific case showed itself pathology.
The first three items are primary congenital disorders. The theme of the fourth point appears as a consequence of the effect on the health of the heart of primary disorders.
A child who is in the womb, if he has this type of heart disease, does not have any difficulties in connection with it. Discomfort appears after birth. Often these children have bluish skin color.
Poor health does not allow him to be mobile. At an early age, the highest percentage of child mortality in this pathology. According to statistics, 25% of sick children, if no surgery is undertaken - die before the year of life. The remaining part may have a backlog in development, both physically and mentally. By the second year of life, the duct can close in the artery.
If by this time the body could not adapt to the situation and did not create a collateral circulation( bypasses), then life becomes compromised. Operation is recommended.
There are cases when the body includes mechanisms that compensate for the disease and therefore survive to adulthood. This:
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The opinion of doctors. .. & gt; & gt;
- muscles of the right ventricle are adjusted to the situation through hypertrophy,
- in the blood vessels is formed a bypass for the flow of blood - collateral circulation,
- lack of oxygen is replaced by erythrocytosis, this carries the risk of blood clots.
This correction is also recommended for correction by surgery.
More details about the characteristics of such a vice as Tetrada Fallot will tell a video of a well-known TV host:
Forms and classification
The vice manifests itself through three phases of the course of the disease.
- It is noted at an early age: from birth to six months. There may be a state where significant deviations from the norm are not noticed.
- Appearance of attacks characterized as dyspnea-cyanotic. In this regard, there are complications with the brain, and possible critical situations with a fatal outcome.
- The body adapts to the pathology, the threshold of the adult period.
The disease is classified according to four points. Expresses the congenital anomaly of the output tract from the right ventricle.
- Tubular
Anomaly is expressed in the malformation of the pulmonary cone of the arterial trunk. It turns out to be shortened and narrowed. - Hypertrophic
Violation is expressed by a deviation in the location of the septum to the left and anteriorly. Maybe its low location. The proximal segment of the septum has hypertrophic changes. Narrowing in the zone of the outlet of the right half. - Embryological
The septum is located low or its displacement is observed in the left side and anteriorly. The maximum restriction is in the delimiting ring. - Multicomponent
Anatomically the pathology is expressed in the fact that the septum is considerably elongated. It may be that the moderator's belt has a high clearance.
Features of blood flow associated with the difference in pressure at different sites, subdivide the tetralogy of Fallot according to clinical and anatomical signs into three forms:
- acyanotic,
- abnormal overlap in the pulmonary artery,
- cyanotic form, there is a varying degree of narrowing of the artery's mouth.
Scheme-photo of Fallot's notebooks
Causes of
The pathology is formed on the first-second months of fetal development and is a consequence of defects in the structure of the heart.
Motivating factors:
- receiving future mother of medicines,
- effect of harmful chemical agents,
- the presence of unfavorable environmental factors,
- if the pregnant woman has had infectious diseases, especially in the early stage of bearing the fetus;
- reception of narcotics, alcohol;
- genetic predisposition.
About the signs of Fallot's Tetrades we will discuss later.
Symptoms of
- One of the most common signs of this disease is the bluish coloration of the skin. The intensity of the color depends on how much blood entering the arterial channel has the ability to be enriched with oxygen. Mixing the blood of two ventricles because of the pathology of the wall or the incorrect location of the pulmonary vessel makes the arterial blood depleted and causes blue skin. At any even light physical exertion, cyanosis increases.
- Shortness of breath occurs at an early age or at other stages of the disease. The slightest physical movements, actions increase dyspnoea. The patient feels a breakdown.
- In the position - squatting down, some relief comes.
- To shortness of breath, dizziness, tachycardia are added.
- Pathology leads to a severe manifestation: dyspnea-cyanotic attacks. Usually they first appear in the period from two to five years. There is a crisis with increased dyspnoea, blue skin, possible cramps and loss of consciousness.
- Children have weak immunity before infectious diseases.
- Children often experience inadequate physical and mental development.
- Patients of adult age with this pathology can develop pulmonary tuberculosis.
On how the Tetrada Fallot looks, you can judge from the following video:
Diagnostics
- The disease is primarily determined through anamnesis: an analysis of apparent abnormalities related to the individual characteristics of the patient:
- cyanosis,
- change in the shape of the last phalanges of the fingers, thickening them;nails take the form of "watch glass";
- sometimes there is a deformation of the chest,
- characteristic noises are determined by listening.
- With the help of an ultrasound of the heart, one can see the anatomical features characteristic of the tetralogy of Fallot.
- ECG provides information on the rhythmic pattern of the state of the myocardium, the presence of deviations from the axis.
- Phonocardiography will give full information about disturbances in rhythms and heart murmurs. The
- MRI of the organ will show the structure disturbances with the smallest details.
- Aortography will clarify the information, whether there are violations of the pulmonary artery, whether the body made detours for the blood flow.
- Radiography will show the shape of the heart, the pulmonary picture - how much it is impoverished.
- Probing can determine if there is communication between the ventricles, the level of pressure in them.
On how the treatment of tetralogy of Fallot in newborn children, read further.
Treatment
A vice is a collection of defects in the anatomical structure. The main method of treatment is correction to varying degrees through surgical intervention.
Scheme of the tetralogy of Fallot
Therapeutic
If surgery is not provided for this period of time, to facilitate the condition with cyanotic cyanotic attacks, therapeutic aid is provided-humidified by air by inhalation.
Medication
If there are attacks, then to improve the general condition of resorting to taking medications. Intravenous administration is prescribed:
- of euphyllin,
- of glucose,
- of sodium bicarbonate,
- of reopolyglucin.
Surgical
There are two types of operational assistance. The choice of method of intervention depends on the age, the complexity of the abnormal deviations.
- Newborns and children of the first years of life, if they are in need of prompt assistance, palliative operations are used. These operations enable the patient to wait for the necessary time for more radical intervention. There is a greater flow of blood into the small circle. This type of operations includes a large group of methods that provide for various corrective interventions. They perform all sorts of shunting and excision of obstacles with the help of special equipment.
- Actions prepare the patient for the second stage of the surgery. They are conducted on the open heart and solve the problem of the maximum possible correction of building defects with the help of plastics.
There are some nuances about anesthesia with Tetrad Phallo. In connection with this, this type of vice creates the prerequisites for hypertension, in anesthesia tactics include the preparatory period before the operation. A specialist prescribes taking medications that can prevent an uncontrolled increase in pressure during surgery. After this, you should continue to monitor this direction.
And now let's find out what it's worth to do not to hear about the diagnosis of Tetrad Fallot.
Prevention of the disease
A careful attitude to one's health will exclude a number of factors that initiate abnormal development of the Fallot's Tetrad in the fetus.
It:
- avoid places with ionizing radiation,
- do not contact harmful chemicals,
- do not consume alcohol,
- in communication with infected patients observe safety precautions,
- comply with hygienic rules to protect themselves against possible infection by diseases;
- not to smoke,
- to plan pregnancy, to communicate on the eve with geneticists and other specialists.
Complications of
Pathology, if not scheduled, can have undesirable consequences:
- stroke,
- arrhythmia,
- heart failure,
- brain abscess.
And now let's find out about the prognosis after the operation with Tetrad Phallo.
Forecast of
At an early age, with operative intervention, the lethal outcome is no more than five percent. This method allows the patient to have a full life.
Unpleasant symptoms go away: shortness of breath, cyanosis, blood normalizes its composition. And without surgery, patients with this diagnosis survive to the age of forty-one only one-twentieth of the sick people.
On how the tetralogy of Fallot during itself manifests itself, we will tell further.
Ailment during pregnancy
If a woman suffering from tetralogy of Fallot does not make adjustments before the fetus with the help of an operative intervention, then her condition deteriorates with the course of pregnancy. Specialists allow palliative surgery during pregnancy, but this measure gives the result of the birth of live children only thirty percent, most of them premature newborns. It is more correct for such patients to make a correction of the condition on time and not leave the situation for the time of pregnancy.
During perinatal life of the fetus, ultrasound can determine from it the structural defects that make up the tetralogy of Fallot. During this period, the violations for the child are not particularly uncomfortable.
Specialists can predict what help they need at birth, when it is better to make a correction. After the birth of a child gets cyanotic skin color.
This may happen later. In mild cases, the skin has a bluish tint or cyanosis is not present at all.
Vaccinations for a child
Questions also raise the possibility of vaccination with Tetrad Phallo. The decision on whether to vaccinate a child is taken by specialists, based on information about the patient's condition, his personal characteristics.
Is disability given in the Fallot Notebook?
Based on the material of the patient's examination, a medical and social examination is carried out. As a result, the severity of the patient's condition is determined and a decision is made to obtain a disability.
More details about the tetralogue of Fallot, as well as other heart defects in toddlers will tell the following video: