Tetralogy of Fallot

Background

  • Most common cyanotic CHD manifesting in postinfancy period
  • Tetralogy:
    • VSD
    • RV outflow obstruction (pulmonic stenosis)
    • Overriding aorta
    • RV hypertrophy

Diagnosis

  • Cyanosis
  • Systolic thrill/ejection murmur, loud S2

Work-Up

DDx

Treatment

  1. Place in knee-chest position
    1. Increases SVR > more blood into pulm ciruclation
  2. Morphine IV
    1. Mechanism of action unclear
  3. Fluids IV
    1. Improves RV filling
  4. Beta blockers IV
    1. Relaxtion of RVOT
  5. Phenylephrine
    1. Similar to knee-chest position

Disposition

See Also

Congenital Heart Disease

Source

UpToDate




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