Tetralogy of fallot

Revision as of 19:28, 25 August 2011 by Jswartz (talk | contribs)

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 0.1-0.2Mg/kg IV or IM
    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