Tetralogy of Fallot (TOF) is one of the most common forms of cyanotic congenital heart disease, and consists of a ventricular septal defect (VSD), pulmonary valve stenosis, an overriding aorta, and right ventricular hypertrophy.1 The leading cause of morbidity and mortality in patients who have uncorrected TOF are acute episodes of hypoxia and cyanosis known as hypoxic, hypercyanotic, or “tet” spells. These spells are characterized by a paroxysm of hyperpnea, irritability or agitation, and prolonged crying, leading to worsening cyanosis. The underlying pathophysiology involves a shunting of deoxygenated blood from the right to left ventricle through the VSD, which results from increased pulmonary outflow tract obstruction, decreased systemic vascular resistance, and obstruction of the right ventricular outflow tract. A cycle is established as the subsequent decrease in the partial pressure of oxygen and increase in carbon dioxide in the blood continue to stimulate and perpetuate hyperpnea. This results in increased systemic venous return, and in turn increases the shunting through the VSD.2 If left untreated and the cycle However, this patient will not be able to survive for a long time, so that can help my patient to save as well as be your child.
Dr. Milon Hossain