DECREASED PULMONARY BLOOD FLOW Blood Flow Pattern

Tetralogy of Fallot
Obstruction of the pulmonary blood flow. Right to left shunting.

Tricuspid Atresia
Tricuspid valve does not develop so no blood can flow from right atrium to right ventricle. Blood flows through an ASD or a patent foramen ovale and through a VSD Profound Cyanosis Tachycardia Dyspnea Older children: chronic hypoxemia and clubbing At risk for: bacterial endocarditis Brain abscess Stroke

Murmur Symptoms

Harsh systolic murmur. *As ductus arteriosis closes, infant becomes: hypoxic cyanotic *Degree of pulmonary stenosis determines degree of symptoms *Other s/s: polycythemia Clubbing Squatting Murmur Poor growth Hypercyanotic spells (aka tet spells) Chest x-ray shows a characteristic boot shape from large right ventricle ECG Echocardiogram Cardiac Cath must do before surgery Prostaglandin E1 to keep ductus arteriosis open Surgical repair done w/in 1st year of life to promote normal growth Palliative (Blalock-Taussig procedure shunt) s/s so bad that surgery is not possible so this is done until

Diagnosis

Chest x-ray Echocardiogram

Treatment

Prostaglandin E1 Surgery (3 stages): 1. Newborn 2. 4-6 months 3. 18 mos. To 6 yrs.

Misc.

surgery is possible. Classic TOF is a combo of all four defects: 1. Ventricular Septal Defect 2. Right Ventricular Hypertrophy 3. Pulmonic Stenosis 4. Aorta overriding the VSD

Complications: dysrhythmias Developmental delays