Tetralogy of Fallot
Tetralogy of Fallot
Tetralogy of Fallot
Fallot
What is Tetralogy of Fallot?
It’s a cyanotic heart defect. This means the patient will have cyanosis
due to a decrease in pulmonary blood flow.
When studying pediatric congenital heart defects, always
let the name of the defect help you.
“RAPS”
Right ventricular hypertrophy
Aorta displacement
Pulmonary stenosis
(goal of the right side is to get the UNOXYGENATED blood to the LUNGS)
1.The un-oxygenated blood
(this is blood that has been “used-up” by your body that
needs to be resupplied with oxygen) enters to the heart
through the SUPERIOR AND INFERIOR VENA CAVA.
o As blood enters in from the superior and inferior vena cava it goes into the
right atrium, down through the tricuspid, and then the left ventricular
Normally, the aortic valve just connects to the left ventricle, but now it is
connecting to the septal defect and is collecting all the blood that is mixing
at the ventricular septal defect.
“Afflict”
Activity (feeding, crying, playing)
• Cyanosis
• Shortness of breath increased breathing
• Fainting…think “activity intolerance”
Nurse’s role with a “Tet spell”:
knee-to-chest position
calm infant
and apply oxygen
Patient may need medication to calm or
to increase systemic vascular resistance (IV fluids etc.)
Fingernail changes (clubbing due to hypoxia) noticeable at about 6 months
Fatigues or faints easily (especially during a “tet spell”….due to low oxygen
levels)
It can include shunt placement to shunt oxygenated blood through the heart,
so oxygen levels are increased
In addition, complete repair can be performed when the child is older enough
to tolerate surgery
(about 6-12 months of age).
This includes placing a patch over the septal wall defect to prevent blood mixing
in the ventricles.
If a child has a severe case of TOF, where there is a severe
defect to the pulmonary valve (blood won’t be able to get to
the lungs) and the newborn is very cyanotic at birth,
Congenital Heart Defects | National Heart, Lung, and Blood Institute (NHLBI). (2018).
Retrieved from https://www.nhlbi.nih.gov/health-topics/congenital-heart-defects
Tetralogy of Fallot Facts | Congenital Heart Defects | NCBDDD | CDC. Retrieved from
https://www.cdc.gov/ncbddd/heartdefects/tetralogyoffallot.html
Thank you!