Among all known heart disease isdisease among those that are the most common. This pathology is found in 6-7% of cases. Among the critical heart disease tetralogy of Fallot diagnosed in only 4% of cases.
This defect occurs because of a birth defectinterventricular septum. Because of this defect are created all the necessary conditions so that the same pressure is present in both ventricles. Right ventricular hypertrophy is usually the result of having to counter normal output flow from the right ventricle. In addition, it plays an important role of exchange of ventricular overload in this pathology development.
Rarely, the disease is combined with the lack ofpulmonary valve. At the same time about 40% of patients have more heart disease. Thus, approximately 3% of patients revealed muscular ventricular septal defect. Approximately one-fourth of all patients have a right-sided aortic arch. Approximately 5-14% of patients with coronary artery anomaly occurs. Moreover, such a disease is nothing more than a discharge of interventricular branch from crossing the ventricle outflow tracts of the right coronary artery.
Causes of tetralogy of Fallot
Most often this disease affects children, inwhich have some form of genetic abnormalities. Such deviations may be DiGeorge syndrome, Patau syndrome, Edwards syndrome, and Down syndrome. In addition, such a defect is often seen in children, whose mother suffers diabetes. Affected children develop such a blemish, whosemothers took during pregnancy, alcohol and drugs. In addition, the risk is high in women who before and during pregnancy, taking a lot of vitamin A.
There are three main phases of the currentsdisease. Each of these phases is characterized by its symptoms. Thus, the first phase usually lasts up to six months. This is a fairly prosperous phase in which the patient fully satisfactory. In this case there is no lag in physical development.
The second phase is usually characterized by age forfrom 6 months to 2 years. In this period of the disease in the patient are observed odyshechno-cyanotic episodes. These attacks often lead to some cerebral complications, and sometimes even death.
Such seizures tend to occur in the presence of absolute anemia. Moreover, the development of mechanisms of attack usuallyIt depends on how sharp will be spasm of the right ventricle infundibulyarnogo department. This spasm as a result leads to the fact that the whole venous blood begins to flow only into the aorta, and this in turn causes the child sharp lack of oxygen in the CNS. our website notes that during the attack, the amount of oxygen that enters the body is reduced to 35%. Systolic murmur is sharply reduced or completely stopped. Because of this, the child with the defect shows a very strong concern. His face marked a pronounced fear, there is cyanosis, his pupils dilate, increasing shortness of breath, and extremities become cold. After some time the child loses consciousness. Soon he appeared convulsions. When a child is in this state, itmaybe even due to lack of oxygen fall into a coma or die. Such attacks may have varying severity and may last from a few seconds to two or three minutes. After the attack, the child is usually quite a long time remains sluggish and sedentary. Sometimes a child's development is marked weakening of voluntary movements. Sometimes it can also occur a severe form of cerebral circulation.
The third phase is the transition phase, ie. E. During its development begin to show symptoms of adult diseases.
Diagnosis of tetralogy of Fallot
When doctors diagnose diseases, especiallybased on the appearance of the patient. In addition, it is important to listen to the dry, rough systolic murmur in the heart. If the EKG is performed, it revealed signs of enlargement of the right heart. During the X-ray determined by the signs, but rather typical changes in which the heart becomes a "wooden shoe". And identify such a typical pattern for this defect, it does not form an enlarged heart shadow and pulmonary drawing depleted. If we draw the ECG, the patient can be determined large axis deviation (at 120-180 degrees), and the right side.
For the diagnosis can be very helpfulechocardiography, but the basic method is still an angiography, which allows you to explore the heart with the help of contrast agents. This method allows you to specify the presence of indications for surgery. In addition, this procedure will allow the planning, the operation will be carried out in what amount.
Tetralogy of Fallot in any case should besubjected to treatment. Moreover, if the defect runs hard, then surgery is performed immediately. This operation is always performed when the patient is connected to a heart-lung machine. Earlier, the operation was carried out in two stages, and now do both steps at a time. However, this is not always the case. Some patients have a radical operation is not possible at a time.
During the surgery, the surgeon fixescongenital ventricular septal defects. Besides the connection is established between the large blood vessel and the pulmonary artery. Moreover, the correction means expanding the narrowed opening of the valve and the pulmonary outflow narrowed extension of the right ventricle.
Mortality during surgery in young childrenage is small enough and does not exceed 5%. After a successful operation the child disappears shortness of breath, cyanosis, become normal test results. At the same time the children after the operation should still be seen by a doctor.