Example Of Term Paper On Tetralogy Of Fallot In Children

ABSTRACT

Tetralogy of Fallot is a serious congenital heart conditions that is defined by the defects it causes in the ventricles and pulmonary artery, which causes issues with breathing and transport of oxygen throughout the body. In infants it may appear as exhaustion and cyanosis of the lips, fingers, and face when crying. Modern surgeons suggest surgical intervention as early as possible; however, in some cases waiting may be necessary. That said parents must limit their child’s activities and know how to calm and soothe their child’s breathing. Surgeries are available today that can repair the deformations and defects and aid these patients to live full and healthy lives. In the past this congenital condition led to a high mortality rate for the infants born with the condition, however today the prognosis for children with Tetralogy of Fallot is promising.

INTRODUCTION

Healthy babies are born every single day. However, most people do not know how lucky they are when that bouncing baby, pops out pink, squalling, and having ten fingers and ten toes comes into the world. If people knew the hundreds, if not thousands, of things that can go wrong in a pregnancy or a child’s development, they would be shocked. There are a plethora of diseases, condition and illnesses that can affect human beings. Some of the most impactful conditions are those that are deemed congenital, existing since birth, some more common and others rarer. Some are treatable, others are even curable. However, that is hardly a comfort when people are worried about their new infant’s health. Babies, particularly newborns, are so helpless and vulnerable and helping them to survive and thrive in an imperative. Tetralogy of Fallot is one of the more common congenital condition that new babies are diagnosed with, in fact, 10% of the babies born with heart conditions are suffering from the effects of this condition (Bailliard & Anderson, 2009). In order to understand the condition better it is best to review its origins, symptoms, treatments and overall prognosis individually.

BACKGROUND

What is Tetralogy of Fallot? In the simplest terms it is a condition, named for the Étienne-Louis-Arthur Fallot, who first recognized the issues in the late 19th century, which is recognized as four telltale symptoms that are the hallmark of this congenital condition.
Ventricular Septal Defect: This is a defect that appears in the wall dividing the left and right ventricles of the heart (Cincinnati Children’s Organization, 2012).
Pulmonary Stenosis: This is a narrowing of the pulmonary valve that leads to an obstruction of the blood that flows from the right ventricle into the pulmonary artery. (Cinncinati Children’s Organization, 2012).
Right Ventricular Hypertrophy: This involves the thickening of the muscular walls in the right ventricle, which stems from the right ventricle pumping with high pressure (Cincinnati Children’s Organization, 2012).
Overriding Aorta: The aorta is enlarged and appears to rise from both the left and right ventricles; instead of just the left ventricle as in a healthy heart (Cinncinati Children’s Organization, 2012).
There are a number of ways that this condition will manifest in children. In infants may recognize that there infant gets tired and breathless while nursing or feedings. They may have cyanosis of the fingers and lips, which may be apparent at birth, and may extend to the face when crying. This often referred to as a “Tet” episode. The infants are often small for their age and suffer from malnourishment and failure to thrive. When undiagnosed and untreated as the baby reaches 3-6 months clubbing of the hands and feet may be present. If the condition remains untreated, most Tetralogy of Fallot sufferers can die, the mortality rate increase to 50% by the age of six (Bhimji & Willis IV, 2014).

DISCUSSION

Diagnosing the condition is not very difficult given all of its definitive symptoms. Hemoglobin tests to determine the severity of the cyanosis, Arterial Blood Gas (ABG) show low or varied oxygen saturation. These tests would be followed by a number of different imaging studies including, Echocardiography, Magnetic Resonance Imaging (MRI) and chest radiographs. Depending of the quality and clarity of the images, the defects and deformities of Tetralogy of Fallot is recognized, some patients may require cardiac catheritization to confirm the certainty of the diagnosis (Bhimji & Willis IV, 2014). Once the diagnosis is determined then the treatment and therapeutic measures that will be most beneficial can be implemented.
Today in the era of cardiac surgeries that are continuing to be innovated each and every day there is a positive prognosis on the horizon. There are surgeries being performed on infants as young as four months, with ultimate goal of complete repair, which ideally will eliminate the need for further surgical measures in the future (Bailliard & Anderson, 2009). However, for infants, toddlers, and young children who have yet to undergo any surgical interventions. Doctors may suggest special diets for the infants with difficulties eating. Children experiencing “Tet” spells will be most benefitted by a measure that are calming, slows breathing, and relieves stress. They suggest techniques to aid in relaxation. One measure is to lay your child down and rest their knees on their chest or have child drop into a squat, which increases blood flow to the lungs (National Institutes of Health, 2011).
In children that are a bit older, toddlers and elementary age children who are living with the condition prior to diagnosis, which is unlikely in the modern era, or in the interim prior to surgical interventions, there are some necessary steps that may need to be taken. Activity restrictions are going to be paramount. Physical education in school must be limited and such children should not play highly active and contact sports. Even regular outdoor play may need to be restricted and limited to avoid the more dangerous aspects, like the difficulties in breathing, associated with Tetralogy of Fallot. However, the most important aspect of caring for a child with this congenial condition is regular visits to their physician and a proactive attitude necessary to meet the medical monitoring and attention that they will need (National Institutes of Health, 2011).These considerations increase with age and carry on into adulthood. However, most modern physicians would recommend repair measures taken the earlier the possible to improve overall quality of life.
The sufferer will need some form of open heart surgery to repair the defects, depending on the extremity and nature of that defect. This will involve a serious initial surgery and the possibilities, at the surgeon’s discretion, of requiring accessory or additional surgeries throughout a period of time. By widening or artificially replacing the pulmonary vessels and enlarging of the right ventricle where it meets the pulmonary artery. These two interventions alone can have a positive impact on the bulk of other defects and issues that may exist (National Institutes of Health, 2011). If these measures are taken then the prognosis for the patient is rather high and entirely encouraging. Today children born with Tetralogy of Fallot with medical monitoring and interventions can live a long, meaningful and full life with little or few side effects or limitations that are caused by this particular heart condition.

CONCLUSION

Tetralogy of Fallot has in the past been a serious cause of child mortality. However, today the medical technologies and innovations has changed those foreboding statistics and created a far more positive prognosis for those infants born with Tetralogy of Fallot. The defects that exist can be repaired and addressed in successful and effective ways and surgeons are suggesting that the repair is most beneficial the younger that they are implemented and surgical intervention allow for the finite surgeries necessary to operate on a small infant. Most parents and physicians would agree that the diagnosis of Tetralogy of Fallot is still a serious one but it no longer carries the potential death sentence that it inevitably was in the generations before them. The continuing research into the causes, effects, and treatments for this condition has and remains worthwhile.

REFERENCES

Bailliard, F., & Anderson, R. (2009). Tetralogy of Fallot. Orphanet Journal of Rare Diseases,
4(2), 1-1.
Bhimji, S., & Willis IV, P. (2014, April 29). Tetralogy of Fallot. Retrieved January 18, 2015,
Cincinnati Children’s Organization. (2012, October 1). Tetralogy of Fallot (TOF) in Children.
Retrieved January 18, 2015, from http://www.cincinnatichildrens.org/health/t/tof/
National Institutes of Health. (2011). Living With Tetralogy of Fallot. National Heart, Lung and
Blood Institute, 1-1.