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| | __NOTOC__ |
| | '''For patient information, click [[Tetralogy of fallot (patient information)|here]]''' |
| {{DiseaseDisorder infobox | | | {{DiseaseDisorder infobox | |
| Name = Tetralogy of Fallot |
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| ICD10 = {{ICD10|Q|21|3|q|20}} |
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| ICD9 = {{ICD9|745.2}} |
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| ICDO = |
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| Image = Tetralogy of Fallot svg.png | | | Image = Tetralogy of Fallot svg.png | |
| Caption = diagram of a healthy heart and one suffering from Tetralogy of fallot |
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| OMIM = 187500 |
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| MedlinePlus = 001567 |
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| eMedicineSubj = emerg |
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| eMedicineTopic = 575 |
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| DiseasesDB = 4660 |
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| MeshID = D013771 |
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| }} | | }} |
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| {{Tetralogy of fallot}} | | {{Tetralogy of fallot}} |
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| '''For patient information click [[Tetralogy of fallot(patient information)|here]]''' | | {{CMG}}; '''Associate Editors-In-Chief:''' {{Fs}}, [[Priyamvada Singh| Priyamvada Singh, M.B.B.S.]] [mailto:psingh13579@gmail.com], '''Assistant Editor-In-Chief:''' [[Kristin Feeney|Kristin Feeney, B.S.]] [mailto:kfeeney@elon.edu] |
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| {{CMG}}
| | ==[[Tetralogy of fallot overview|Overview]]== |
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| '''Associate Editors-In-Chief:''' [[User:KeriShafer|Keri Shafer, M.D.]] [mailto:kshafer@bidmc.harvard.edu]; Atif Mohammad, M.D., [[Priyamvada Singh]], [[MBBS]]
| | ==[[Tetralogy of fallot historical perspective|Historical Perspective]]== |
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| ===[[Tetralogy of fallot diagram | Tetralogy of fallot diagram ]]===
| | ==[[Tetralogy of fallot classification|Classification]]== |
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| ===[[Tetralogy of fallot overview | Tetralogy of fallot overview ]]===
| | ==[[Tetralogy of fallot pathophysiology|Pathophysiology]]== |
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| ===[[Tetralogy of fallot anatomy | Tetralogy of fallot anatomy]]===
| | ==[[Tetralogy of fallot causes|Causes]]== |
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| ===[[Tetralogy of fallot pathophysiology | Tetralogy of fallot pathophysiology]]===
| | ==[[Tetralogy of fallot differential diagnosis|Differentiating Tetralogy of Fallot from other Diseases]]== |
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| ===[[Tetralogy of fallot epidemiology and demographics | Tetralogy of fallot epidemiology and demographics ]]===
| | ==[[Tetralogy of fallot epidemiology and demographics|Epidemiology and Demographics]]== |
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| ===[[Tetralogy of fallot natural history, complications and prognosis | Tetralogy of fallot natural history, complications and prognosis ]]===
| | ==[[Tetralogy of fallot risk factors|Risk Factors]]== |
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| ===[[Tetralogy of fallot causes | Tetralogy of fallot causes]]===
| | ==[[Tetralogy of fallot screening|Screening]]== |
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| ===[[Tetralogy of fallot differential diagnosis |Tetralogy of fallot differential diagnosis]]===
| | ==[[Tetralogy of fallot natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
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| ===Tetralogy of fallot diagnosis|Tetralogy of fallot diagnosis===
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| ===[[Tetralogy of fallot history and symptoms|Tetralogy of fallot history and symptoms]]===
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| ===[[Tetralogy of fallot physical examination|Tetralogy of fallot physical examination]]===
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| ===Tetralogy of fallot lab studies|Tetralogy of fallot lab studies===
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| ===[[Tetralogy of fallot electrocardiogram|Tetralogy of fallot electrocardiogram]]===
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| ===[[Tetralogy of fallot chest xray|Tetralogy of fallot chest xray]]===
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| ===[[Tetralogy of fallot echocardiography|Tetralogy of fallot echocardiography]]===
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| ===[[Tetralogy of fallot cardiac catheterization|Tetralogy of fallot cardiac catheterization ]]===
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| ===[[Tetralogy of fallot other tests|Tetralogy of fallot other tests ]]===
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| ===[[Tetralogy of fallot treatment |Tetralogy of fallot treatment]]===
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| [[ACC/AHA guidelines tetralogy of fallot|ACC/AHA guidelines tetralogy of fallot]]
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| [[Tetralogy of fallot surgical techniques|Tetralogy of fallot surgical techniques ]]
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| ===[[Tetralogy of fallot prognosis|Tetralogy of fallot prognosis]]===
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| [[Tetralogy of fallot prevention |Tetralogy of fallot prevention]]
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| ==References==
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| {{reflist|2}}
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| == External Links for VSD ==
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| * [http://www.pediatricheartsurgery.com Pediatric Heart Surgery]
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| * [http://www.youtube.com/user/Redmond111 The Congenital Heart Surgery Video Project]
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| * [http://www.youtube.com/watch?v=Uf_tRlG1nMc VSD Repair, Perimembranous Ventricular Septal Defect]
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| * [http://www.scribd.com/doc/5563960/VSD-Ventricular-Septal-Defect-Repair VSD Repair Powerpoint™ Presentation]
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| ==Acknowledgements and Initial Contributors to Page==
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| Leida Perez, M.D.
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| Redmond Burke M.D.
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| ==References== | |
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| {{Reflist|2}}
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| {{Congenital malformations and deformations of circulatory system}}
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| {{SIB}}
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| [[de:Herzfehler]]
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| [[es:Cardiopatía congénita]]
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| [[fr:Cardiopathie congénitale]]
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| [[lv:Iedzimtās sirds slimības]]
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| [[nn:Medfødd hjartefeil]]
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| [[pl:Wada serca]]
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| [[pt:Cardiopatia congênita]]
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| [[sr:Урођене срчане мане]]
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| [[uk:Вроджені вади серця]]
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| [[wa:Maladeye des bleus påpåds]]
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| [[tr:Doğumsal kalp hastalıkları]]
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| [[Category:Cardiology]]
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| [[Category:Congenital heart disease]]
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| [[Category:Genetic Disease]]
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| {{WikiDoc Help Menu}}
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| {{WikiDoc Sources}}
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| #Arterial oxygen desaturation is evident, as is compensatory erythrocytosis, the magnitude of which is proportional to the severity of the desaturation.
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| | ==Diagnosis== |
| | [[Tetralogy of fallot diagnostic study of choice|Diagnostic study of choice]] | [[Tetralogy of fallot history and symptoms|History and Symptoms]] | [[Tetralogy of fallot physical examination|Physical Examination]] | [[Tetralogy of fallot lab studies|Laboratory Findings]] | [[Tetralogy of fallot electrocardiogram|Electrocardiogram]] | [[Tetralogy of fallot chest xray|X-Ray Findings]] | [[Tetralogy of fallot echocardiography|Echocardiography]] | [[Tetralogy of fallot CT|CT-Scan Findings]] | [[Tetralogy of fallot MRI|MRI Findings]] | [[Tetralogy of fallot other imaging findings|Other Imaging Findings]] | [[Tetralogy of fallot other diagnostic studies|Other Diagnostic Studies]] |
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| ==Treatment== | | ==Treatment== |
| Tetralogy of Fallot is treated on two levels: with immediate emergency care for hypoxic or "tet" spells and with corrective surgery. | | [[Tetralogy of fallot medical treatment|Medical Therapy]] | [[Tetralogy of fallot surgical techniques|Surgery]] | [[Tetralogy of fallot interventions|Interventions]] | [[Tetralogy of fallot primary prevention|Primary Prevention]] | [[Tetralogy of fallot secondary prevention|Secondary Prevention]] | [[Tetralogy of fallot cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Tetralogy of fallot future or investigational therapies|Future or Investigational Therapies]] |
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| ===Emergency management of tet spells===
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| Consequential acute hypoxia may be treated with [[beta-blockers]] such as [[propranolol]], but acute episodes may require rapid intervention with [[morphine]] to reduce ventilatory drive and [[phenylephrine]] to increase blood pressure. Oxygen is ineffective in treating hypoxic spells because the underlying problem is lack of blood flow through the pulmonary circuit and not alveolar oxygenation. There are also simple procedures such as the knee-chest position which increases aortic wave reflection, increasing pressure on the left side of the heart, decreasing the right to left shunt thus decreasing the amount of deoxygenated blood entering the systemic circulation.<ref>{{cite journal |author=Murakami T |title=Squatting: the hemodynamic change is induced by enhanced aortic wave reflection |journal=Am. J. Hypertens. |volume=15 |issue=11 |pages=986-8 |year=2002 |pmid=12441219}}</ref>
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| ===Palliative surgery===
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| The condition was initially thought untreatable until surgeon [[Alfred Blalock]], cardiologist [[Helen B. Taussig]], and lab assistant [[Vivien Thomas]] at Johns Hopkins University developed a surgical procedure, which involved forming an anastomosis between the subclavian artery and the pulmonary artery. It was actually Helen Taussig who convinced Alfred Blalock that the shunt was going to work. This redirected a large portion of the partially oxygenated blood leaving the heart for the body into the lungs, increasing flow through the pulmonary circuit, and greatly relieving symptoms in patients. The first [[Blalock-Thomas-Taussig shunt]] surgery was performed on 15-month old Eileen Saxon on November 29, 1944 with dramatic results.
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| The Pott shunt and the Waterson procedure are other shunt procedures which were developed for the same purpose.
| | ==Case Studies== |
| | [[Tetralogy of Fallot case study one|Case #1]] |
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| Currently, Blalock-Thomas-Taussig shunts are not normally performed on infants with TOF except for severe variants such as TOF with pulmonary atresia.
| | ==Related Chapters== |
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| ===Total surgical repair=== | |
| The Blalock-Taussig procedure was the only surgical treatment until the first total repair was performed in 1954. Between 1944 and when total repair became available at major surgical centers in the early 1960s, many infants and children were treated with Blalock-Taussig procedures.
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| The total repair was performed by [[C. Walton Lillehei]] at the University of Minnesota in 1954 on a 10-month boy. Total repair initially carried a high mortality risk which has consistently improved over the years. Surgery is now often carried out in infants 1 year of age or younger with a <5% perioperative mortality. The surgery generally involves making incisions into the heart muscle, relieving the right ventricular outflow tract stenosis by careful resection of muscle, and repairing the VSD using a Gore-Tex or Dacron patch or a homograft. Additional reparative or reconstructive work may be done on patients as required by their particular anatomy.
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| Patients who have undergone "total" repair of tetralogy of Fallot often have good to excellent cardiac function after the operation with some to no exercise intolerance and have the potential to lead normal lives. Surgical success and long-term outcome greatly depends on the particular anatomy of the patient and the surgeon's skill and experience with this type of repair.
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| ==See also==
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| * [[Trilogy of Fallot]] | | * [[Trilogy of Fallot]] |
| * Pentalogy of Fallot
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| ==References==
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| {{Reflist|2}}
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| ==External links==
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| * [http://heartcenter.seattlechildrens.org/conditions_treated/tetralogy_of_fallot.asp Tetralogy of Fallot information] from Seattle Children's Hospital Heart Center
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| * [http://www.med.umich.edu/cvc/mchc/partet.htm Information] by University of Michigan Health System
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| * [http://www-medlib.med.utah.edu/WebPath/CVHTML/CV102.html Diagram of the condition]
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| * [http://www.achaheart.org/resource/icon_cheartdefects_tdf.php Information for adults with ToF] from the Adult Congenital Heart Association
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| * [http://www.geocities.com/tet_of_fallot1/welcomepage.html Michael Warman's Website on ToF]
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| {{Congenital malformations and deformations of circulatory system}}
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| {{Electrocardiography}}
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| {{SIB}}
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| [[de:Fallot-Tetralogie]]
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| [[fr:Tétralogie de Fallot]] | | [[fr:Tétralogie de Fallot]] |
| [[it:Tetralogia di Fallot]]
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| [[nl:Tetralogie van Fallot]]
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| [[nn:Fallots tetrade]]
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| [[ja:ファロー四徴症]] | | [[ja:ファロー四徴症]] |
| [[pl:Tetralogia Fallota]] | | [[pl:Tetralogia Fallota]] |
| [[ru:Тетрада Фалло]] | | [[ru:Тетрада Фалло]] |
| [[uk:Тетрада Фалло]]
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| [[zh:法乐氏四联症]] | | [[zh:法乐氏四联症]] |
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| [[Category:Cardiology]] | | [[Category:Cardiology]] |
| [[Category:Congenital heart disease]] | | [[Category:Congenital heart disease]] |
| | | [[Category:Pediatrics]] |
| {{WikiDoc Help Menu}} | | [[Category:Disease]] |
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