tetralogy_of_fallot_flashcards
What is the management for severe Tetralogy of Fallot with worsening cyanosis?
Prostaglandin E1 infusion, Blalock-Taussig shunt (artificial tube between the subclavian artery and pulmonary artery).
What is the definitive treatment for Tetralogy of Fallot?
Total surgical repair by open heart surgery, performed from 4 months of age onwards.
What does the definitive surgical treatment for Tetralogy of Fallot involve?
Closing the VSD and relieving right ventricular outflow tract obstruction.
What are hypercyanotic spells ‘tet spells’?
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.
What is the initial management for hypercyanotic spells?
Place the patient in the knee-to-chest position, provide supplementary oxygen, and administer IV fluids.
What medications are used to manage hypercyanotic spells?
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).