tetralogy_of_fallot_flashcards

Question 1

What is the management for severe Tetralogy of Fallot with worsening cyanosis?

Answer 1

Prostaglandin E1 infusion, Blalock-Taussig shunt (artificial tube between the subclavian artery and pulmonary artery).

Question 2

What is the definitive treatment for Tetralogy of Fallot?

Answer 2

Total surgical repair by open heart surgery, performed from 4 months of age onwards.

Question 3

What does the definitive surgical treatment for Tetralogy of Fallot involve?

Answer 3

Closing the VSD and relieving right ventricular outflow tract obstruction.

Question 4

What are hypercyanotic spells ‘tet spells’?

Answer 4

Intermittent symptomatic periods when the right to left shunt becomes temporarily worsened, either due to an increase in the pulmonary vascular resistance or a decrease in the systemic vascular resistance.

Question 5

What is the initial management for hypercyanotic spells?

Answer 5

Place the patient in the knee-to-chest position, provide supplementary oxygen, and administer IV fluids.

Question 6

What medications are used to manage hypercyanotic spells?

Answer 6

Beta blockers (relax the right ventricle and improve flow to the pulmonary vessels), morphine (decrease the respiratory drive), sodium bicarbonate (counteracts any metabolic acidosis), phenylephrine infusion (increase systemic vascular resistance).