hedieh
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Tetralogy of Fallot, page 182:
(6) cardioprotetctive shunts increase oxygenation
(a) ASD sets up SaO2 in righ atrium
(b) PDA shunts blood from the aorta to the pulmonary artery
What did he mean?????????????
What is the correlation of ASD or PDA with tetralogy of Fallot?
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| edie
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In this case, if there are septal defecta or patent ductus, they won't be repaired because they help increase overall oxygenation of the blood in TOF. Did you listen to the lecture yet? He explains it better in the lecture 
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| hedieh
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Thanks Edie, I didnot listen to lecture yet. So he means if there are ASD or PDA they help the patient ( they are not always present, sometimes they are). Did I understand correctly?
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| edie
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hedieh wrote:
Thanks Edie, I didnot listen to lecture yet. So he means if there are ASD or PDA they help the patient ( they are not always present, sometimes they are). Did I understand correctly?
Right, Hedieh, it's the body's way of accommodation for an imperfect situation 
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| hedieh
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Thanks, Edie.
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| new_n_lost
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the PDA causes the Less Oxygenated Blood from the Aorta back into the Pulmonary artey so tht the blood gets more oxygenated while the ASD does the same by causing the Oxygenated blood coming in from the Lungs to get recycled back into the Pulmonary Circuit so that When the Blood Reaches the Aorta the oxygenation gets improved.
In TOF the major complication is the VSD and the Stenosed Rgith Ventricular Outflow Area. VSD can creates a major bypass for the blood from Right Ventricle to Left Ventricle ( A Rgiht to Left Shunt). The Presence of an ASD and PDA help to keep the Shunt Reversed as does squatting.
If U guys Want or have questions this wud be a good place to Discuss this topic.
Any Questions Plz Shoot.
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| efti
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I have a question for you guys:
Let's say a child is born with Tetralogy of Fallot and patent PDA - what do you administer to maintain PDA patent?
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| yoga
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patency is maintained by prostaglandin
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| yoga
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2 clost PDA:
Rx: prostaglandin inhibitor, also histmaine, Ach, Catecholamine promote closure
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| efti
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So you tell the nurse 'Please administer prostaglandin' ? Name of the drug please And when it comes to PDA closure - the DOC is indomethacin.
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| yoga
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u want commercial name?!
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| efti
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The answer is Misoprostol (prostaglandin E1 (PGE1) analogue).
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| yoga
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misopristol misopristol misopristol
ok i will remember it
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| hedieh
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I cannot understand it. So do all children with TF have a coexisting PDA or ASD?
So why do they call it Tetralogy? and always talk about four structral disorders?
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| edie
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There are four main pathological features--> tetra=four in Latin (or Greek, not sure).
Pulmonic stenosis
Right ventricular hypertrophy
Over-riding aorta
Ventral septal defect
Try looking up each in Robbins for thorough understanding. Mnemonic: PROVe
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| edie
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Not sure if the PDA is in all cases of TOF. Anyone else know?
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| hedieh
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edie wrote:
There are four main pathological features--> tetra=four in Latin (or Greek, not sure).
Pulmonic stenosis
Right ventricular hypertrophy
Over-riding aorta
Ventral septal defect
Try looking up each in Robbins for thorough understanding. Mnemonic: PROVe
That's exactly my question. I know tetra means four, and I also read the four basic components of TF. So my question is:
Do all of TF children have ASD or PDA? If so, why do they call it tetralogy? If not so, which children have ASD or PDA and which haven't?
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| edie
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May be going out on a limb here, but TOF is always diagnosed with those four. I think that they MAY present with the additional PDA and ASD, I don't think they always do in every case. I'll check it out and post later.
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| edie
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From Wiki:
Other variations
There is anatomic variation between the hearts of individuals with tetralogy of Fallot. The degree of right ventricular outflow tract obstruction varies between patients and is generally determines clinical symptoms and disease progression. Tetralogy of Fallot may present with other anatomical anomalies, including:
- stenosis of the left pulmonary artery, in 40% of patients
- a bicuspid pulmonary valve, in 40% of patients
- right-sided aortic arch, in 25% of patients
- coronary artery anomalies, in 10% of patients
- an atrial septal defect, in which case the syndrome is sometimes called a pentalogy of Fallot
- an atrioventricular septal defect
- partially or totally anomalous pulmonary venous return
- forked ribs and scoliosis
Tetralogy of fallot with pulmonary atresia or pseudotruncus arteriosus is a severe variant in which there is complete obstruction of the right ventricular outflow tract and absence of the pulmonary trunk. In these individuals, there is complete right to left shunting of blood. The lungs are perfused via extensive collaterals from the systemic arteries.
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| new_n_lost
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The Presence of an ASD makes it a Pentad Otherwise the Tetralogy is the same as Edie Mentioned. ASD is frequently present but not in all the cases to make it included into the TOF so is PDA. They co exist but r not part of TOF.
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| hedieh
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Thanks, edie,it was useful.
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