Tetralogy of Fallot

Cardiology (12%) Core Clinical Conditions

2B: The Physician Associate is able to undertake the day to day management of the patient and condition once the diagnosis and strategic management decisions have been made by another.

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Definition Aetiology Pathophysiology Risk factor Sign and Symptoms Investigations Management

Tetralogy of fallot is a congenital heart defect with 4 features:  an overriding aorta, pulmonary stenosis, large ventricular septal defect and right ventricular hypertrophy.

Combination of genetic and environmental factors.

As a result of the numerous heart abnormalities, the right ventricle pressure increased, resulting in less oxygenated blood being pumped to the lungs. This results in decreased perfusion to the body and cyanosis, characterised by the skin and mucous membranes taking on a bluish skin colour.

• A history of congenital heart defects in the family.

• Utilisation of specific medications during pregnancy.

• Some genetic disorders.

• Cyanosis. 

• Shortness of breath (SOB).

• Fatigue.

• Heart murmur.

• Failure to thrive.

• Foetal screening ECHO. 

• Physical exam: severe cyanosis at birth.

• Antenatal uss - performed in suspected mothers.

• CXR ( boot-shaped heart ).

• ECG: RBBB (after surgery).

• Emergency surgery.

• If surgery can’t be performed immediately, symptom relieve e.g oxygen therapy, painkiller and beta-blockers.

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