Tetralogy of Fallot Essay Example

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TETRALOGY OF FALLOT 8

Tetralogy of Fallot

Sheyanne Freeman

Lee College

Tetralogy of Fallot

Tetralogy of Fallot is a common form of a congenital cardiac condition characterized by cyanosis (Apitz, Webb & Redington, 2009). This condition arrives at its name from the French physician named Etienne Fallot from the 1600s. Like many other cardiac problems, congenital heart surgeons could manage effectively Tetralogy of Fallot (Apitz, Webb, & Redington, 2009). Surveys done in most countries indicate that children born with Tetralogy of Fallot have managed to survive until old age. In general, this condition has been argued as one of the success stories of the medical field since the 1950s. However, new issues have emerged relating to the management of the condition such as unforeseen medical problems (Apitz, Webb, & Redington, 2009). In this paper the subject to discuss is Tetralogy of Fallot in light of the developmentsin the unexplored aspects of the condition. In particular, the paper gives a closer look at the likely causes, diagnosis, management, and possible medical complications.

Discussion

Tetralogy of Fallot is a congenital cardiac defect. A congenital defect implies that it is present at birth (Apitz, Webb, & Redington, 2009). This condition results from a malformed heart structure that normally impairs typical blood flow. Studies have indicated that Tetralogy of Fallot entails four main heart complications: A large ventricular septal defect, pulmonary stenosis, right ventricular hypertrophy, andan overriding aorta (Apitz, Webb, & Redington, 2009). The Ventricular Septal Defect (VSD) is characterizedby an unusual opening that appears in-between the right and the left ventricles. Pulmonary Stenosis involves a constricted outflow of blood in the pulmonary tract connectedby a valve (Apitz, Webb & Redington, 2009). An overriding aorta presents a complication in the aorta. In this particular defect, the aorta is shiftedover to the right ventricle rather than coming out through the left ventricle. Last, right ventricular hypertrophy is a Tetralogy of Fallot defect that is as a result of a condensed muscular wall of the right ventricle (Apitz, Webb & Redington, 2009).

Causes of Tetralogy of Fallot

Like many congenital cardiac defects, Tetralogy of Fallot does not have a pinpointedcause (Lee, C.H. Lee, Kim, Lim, Chang, Kang, Jo, W.H. Kim, 2006). However, the following factors have been seen to amplify the chances and risks of the condition the during pregnancy period. They include:

  • Alcohol consumption by the expecting mothers

  • A diabetic condition by the mother

  • Older expecting mothers; more than40 years

  • Deprived nutrition at the time of pregnancy

  • Viral illnesses such as Rubella during the gestation period

Symptoms of Tetralogy of Fallot

Children suffering from Tetralogy of Fallot will experience soaring levels of chromosomal disorders including Down syndrome and DiGeorge syndrome. More specific symptoms include:

  • Clubbing: the bulging of the skin or the bones around the fingernails

  • Cyanosis: the formation of a bluish coloration on the child’s skin, lips, and his or her fingernails as a result low oxygen levels. Cyanosis will increase in magnitude as the baby becomes angry.

  • Pronounced poor feeding habits and complicatedness in feeding

  • Passing out and under weightiness

  • Stunted growth

  • Squatting, especiallyat the time of cyanosis

Diagnosing for Tetralogy of Fallot

Since the 1950s, doctors have diagnosed successfully Tetralogy of Fallot basing the child’s symptoms. This follows a physical examination and the analysis. During routine checkups, a doctor may observe signs and symptoms associated with the condition in the first few weeks of the child’s neonatal life (Lee, et al. 2006). The signs might also be noticed by the mother, especiallyin feeding.

The child diagnosed with Tetralogy of Fallot condition will be put under the care of a pediatric cardiologist and a cardiac surgeon (Lee, et al. 2006). During the physical examination, the doctor will use simple means such as a stethoscope to observe the baby’s heart beat. The doctor will also be interested to note on any tint on the baby’s skin and the general body appearance (Lee, et al. 2006). The doctor will particularly observe:

  • An x-ray of the chest

  • Complete Blood Count (CBC)

  • Echocardiogram

  • Electrocardiogram (EKG)

  • Magnetic Resonance Imaging (MRI), usually after surgery of the heart

  • Pulse Oximetry

  • Cardiac Catheterization

Specific Nursing Interventions for Tetralogy of Fallot

Dealing with Tetralogy of Fallot could be quite a challenging task. A RN is expected to carry out steps aimed at combating the condition. The RN can choose to use β-blockers and administer morphine in order to restrain spasm of the right ventricle. Similarly, if the condition becomes relatively severe, the RN will bring the affected child to a knee-chest position. This boosts the blood pressure in the left ventricle of the heart. The RN is also required to offer the child oxygen support and bicarbonate.

Types of RNs who are associated with Tetralogy of Fallot

Treatment and management of Tetralogy of Fallot brings on board a number of RNs. They include: Surgeons and Pediatric cardiologists. Pediatric cardiologists specialize in cardiac complications involving infants whereasa cardiac surgeon operates on cardiac defects by means of surgery.

Management and Treatment of Tetralogy of Fallot

One way of treating the Tetralogy of Fallot condition is through an open heart surgery.This is doneat the moment of birth or at a later stage during childhood (Lee, et al. 2006). The essence of the surgery is to fix the identified cardiac defects and allow for normal blood flow. Many medical practitioners have seen this as a good way to increase the child’s chances of survival and quality of life. The best time for the surgical operation will be decidedby the pediatric cardiologist depending with how serious the condition (Lee, et al. 2006).

Sometimes, the cardiologist will recommend more than one surgical operation. In such cases, the first surgical operation will aid in boosting blood flow to the patient’s lungs and hence enough oxygen supply. The operation takes two forms: Complete Intra-cardiac Repair or Temporary/Palliative Surgery. In both procedures, the aim is to improve the flow of blood thereby availing oxygen where it is needed (Lee, et al. 2006).
Complete Intra-cardiac Repair, which involves an incision the cardiologist, makes to see to the heart. Temporary/Palliative Surgery entails placing a tube (shunt) between the aorta and the pulmonary artery with the aim of making a supplementary alleyway for blood to reach the lungs for oxygen (Lee, et al. 2006). The shunt will later be removed.

Outlook (Prognosis)

According to studies done, most cases of the Tetralogy of Fallot condition can be repairedby surgical operations. It is argued that 90% of the children who undertake these operations will grow up better than those who do not (Lee, C-H Lee, Kim, Lim et al. 2006). These children will lead a fairly normal, active, and productive life, unlike, the others who do not. If surgery is not done, doctors have suggested that there is a sure chance that the child will not survive past 20 years. Even with the surgery, it is advisable that the cardiologist monitors the child’s Arrhythmias (Lee, et al. 2006).

Possible Medical Complications

Although management and treatment of the Tetralogy of Fallot condition has been said to be a success, a developmentin this concept has revealed that initial studies ignored the concern regarding medical complications of the procedures involved (Lee, et al. 2006). Recent studies suggest that management of the Tetralogy of Fallot condition may come with the following complications:

  • Stunted or delayed growth

  • Arrhythmias e.g., uneven heart rhythms

  • Occasional seizures, especiallywhen there is a limitedsupply of oxygen

Conclusion

Tetralogy of Fallot is a cardiac condition manifestedby cyanosis. Like many congenital illnesses, it does not have one main cause although a number of causative agents have been identified. Through surgery, the condition can be treated. This paper looked at Tetralogy of Fallot in the light of the developments in the unexplored aspects of the condition. In particular, the paper gave a closer look at the likely causes, diagnosis, management, and the possible medical complications.

Even with possible surgical operations to the patients, it emerges that there is a risk for patients to develop pulmonary valvular regurgitation after their first operation. To deal with the problem, it is advisable that doctors employ alternative methods. This paper recommends that patients get pulmonary valve replacement instead. In addition, owing to the advances in the percutaneous know-how as well as tissue engineering, this paper proposes a consideration of procedures related to such technologies as a way of minimizing overreliance on pericardial homograft.

References

Apitz, C., Webb, G., & Redington, A.(2009). Tetralogy of Fallot. The Lancet, 374(9699), 1462-71. Retrieved from ProQuest Nursing & Allied Health Source.doi: 1888192481

C. Lee, C.H. Lee, S.C. Kim, C. Lim, Y.H. Chang, C.H. Kang, W.M. Jo, & W.H. Kim, (2006). Outcome after one-stage repair of Tetralogy of Fallot. Journal of Cardiovascular Surgery, 47(1), 65-70. Retrieved from ProQuest Nursing & Allied Health Source. doi: 1023494331