Tetralogy of Fallot (TOF) - Review of Findings

Comment

Comment by Bilal Munir on January 21, 2009 at 5:19am

Clinical Presentation:
Cyanotic Infant,Digital Clubbing of hands and feet,Failure to Thrive.The characteristic feature of the disease is Tett Spells which implies increasing Cyanosis mostly on exertion(Like when the baby Feeds)
Diagnosis:
Echocardiography is the investigation of Choice
Management:
1)Surgical Repair of Defect
2)Tett spells are treated with Oxygen,Morphine and keeping the baby in knee chest position.The incidence of Tett spells canbe minimized by Propanolol which is believed to reduce Infundibular Spasm(beneath the pulmonary Artery)

Comment by Bilal Munir on January 21, 2009 at 5:12am

Since RadRounds team has uploaded the case of TOF it is important to discuss the basics of the disease
Embryology of Defect:
The primitive heart which develops from mesoderm has originally five chambers
1)Truncus Arteriosus
2)Bulbous Cordis
3)Sinus Venosus
4)Primitive Atria
5)Primitive Ventricle
Truncus Arteriosus is divided by a septum called AorticoPulmonary Septum,which is a derivative of Neural Crest cells.This Spiral shaped Septum divides Truncus Arteriosus into Pulmonary Artery and Aorta and responsible for their adult position.In TOF the septum which normally divides Truncus Arteriosus in the midline is shifted more towards one direction which is responsible for the narrow orifice of Pulmonary artery and overriding Aorta.

Comment by saeed rad on January 20, 2009 at 3:20pm

Nice colorful presentation.