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Tetralogy Of Fallot

What is Tetralogy of Fallot?

The term ‘tetralogy of Fallot’ is used to describe the situation when a child suffers from four distinct and different congenital heart diseases since the time of birth.

These congenital defects are the ones that cause malformation of the heart’s structure and result in oxygen-deficient blood flow from the heart to the body. An infant born with the Tetralogy of Fallot is mostly seen with a blue-tinged skin tone due to the insufficient level of oxygen in the blood.

This condition is mostly identified during infancy or soon after the birth if the symptoms are more noticeable. If the signs are not significant enough a person might not show any clear symptoms till later in their life.

Tetralogy Of Fallot

What is the difference between a normal heart & a Tetralogy of Fallot heart?

There are four distinct differences that identify the condition of Tetralogy of Fallot in a person.

These are:

1. Pulmonary Infundibular Stenosis

This heart condition causes the outflow tract of the right ventricle to become abnormally narrowed. This stenosis can occur either in the pulmonary valve or just below it. The narrowing of the lower portion of the pulmonary valve is mostly a result of over-development of the muscles in the heart wall and is known as ‘hypertrophy of the septoparietal trabeculae’. At times this stenosis can also occur due to the over-development of the heart wall muscles near the aorta.

2. Overriding Aorta

This is the result of an aortic valve that is connected to both the ventricles and is located above the ventricular septal defect. The extent of the aorta’s attachment to the right ventricle is known as the degree of ‘override’. The root of the aorta may be displaced toward the front or above the septal defect.

3. Ventricular Septal Defect (VSD)

This is the result of the formation of a hole in the chamber wall of the two ventricles. This hole is mostly seen as being singular and large in nature.

4. Right ventricular hypertrophy

This condition causes the right ventricle to become excessively muscular and shapes into a boot-shape appearance. To compensate for this malformation of the external ventricular septum the wall of the right ventricle increases its size.

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Signs and Symptoms of the Tetralogy of Fallot

 

Symptoms of the Tetralogy of Fallot

The commonly seen signs and symptoms of the tetralogy of Fallot are:

  • Cyanosis (oxygen deficient blood) causes the skin to acquire a bluish tinge.
  • Hyperventilation and shortness of breath is seen during physical activity or while feeding.
  • Fainting spells are usual.
  • Fingers and toes show abnormal round shape (clubbing).
  • Less weight gain.
  • Fatigue
  • Irritability
  • Excessive crying
  • Heart murmur (arrhythmia)

Tet spells

The lack of sufficient oxygen in the blood causes the infant/child to develop bluish skin tone after any physical activity, crying or feeding. This is more common in infants from 2-4 months old.

How is a Tetralogy of Fallot diagnosed?

In case the doctor suspects the baby to be suffering from Tetralogy of Fallot he/she may refer to a pediatric cardiologist to conduct a physical test as well as other diagnostic tests such as:

1. Echocardiography

This diagnostic technique uses high-frequency sound waves to create an image of the heart that can be seen in a video monitor. Echocardiography lets the doctor to identify the presence of ventricular septal defect (VSD) and its location. It also lets the doctor to determine whether the pulmonary artery and the pulmonary valve show a structural defect, as well as to see the functioning of the right ventricle and the position of the aorta.

2. Electrocardiogram

This test is helpful in recording the electrical activity of the heart every time it contracts. This test involves placing patches with electrodes (wires) on the baby’s chest, ankles and wrists to record the electrical activity during each contracture of the heart beat.

This is a test to determine if the baby’s right ventricle is larger than normal, if the right atrium is enlarges and also to see if arrhythmia (irregular heart beat) is present.

3. X-Ray

A chest x-ray helps the doctor see the structure of the lungs and the heart of the baby. This test enables the doctor to identify the abnormal ‘boot-shape’ of the heart due to the presence of excessive muscles in the right ventricle.

4. Pulse oximetry

This test measures the level of oxygen in the blood through a sensor attached to the baby’s finger or toe.

5. Cardiac Catheterization

This test uses a catheter (small, thin and flexible tube) which is inserted into the artery of vein of the baby to evaluate the best option for treatment of Tetralogy of Fallot. A synthetic dye is injected into the blood stream that makes the baby’s heart more clearly visible in an x-ray. This test also helps measure the oxygen level and the pressure in the blood vessels as well as the chambers of the heart.

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Treatment for Tetralogy of Fallot

 

Treatment for Tetralogy of Fallot

The surgical option is considered the best way to treat the conditions causing Tetralogy of Fallot.

These are of two types:

1. Intra-cardiac repair

This is a conventional open-heart surgery and is performed during the first year of the baby’s life. This surgery aims to close the ventricular septal defect (VSD) in the wall between the ventricles (lower two chambers) of the heart with the aid of a synthetic mesh/patch.

This surgery is also useful in repairing, or substituting, the narrowed pulmonary valve as well as to widen the pulmonary arteries to increase the blood flow to normal levels. This surgery helps in removing the oxygen deficiency in the baby’s blood level and hence lessens the symptoms in turn.

2. Temporary surgery

This surgery is required before the intra-cardiac repair surgery in case the baby is seen to suffer from hypoplastic (underdeveloped pulmonary arteries) or is prematurely born. This surgery is performed to create a bypass (placement of a shunt) between the large aortic artery and the pulmonary artery.

This allows the blood flow to rise to normal levels between the heart and the lungs and decreases the risks of any unwanted complications from arising during, or after, the intra-cardiac repair surgery.

Why choose IndianMedTrip for treatment of Tetralogy of Fallot?

IndianMedTrip has been the forerunners of pediatric cardiac treatments since a long time in India. The team of experts at IndianMedTrip is experienced in managing the travel, stay, hospitalization and all other itinerary factors efficiently in order to ensure a smooth and hassle-free treatment for your baby in India. IndianMedTrip is also known for offering the lowest cost treatment for Tetralogy of Fallot in India.

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