Tetralogy of fallot treatment


 * Associate Editors-In-Chief: Priyamvada Singh, MBBS [mailto:psingh@perfuse.org]; ; Keri Shafer, M.D. [mailto:kshafer@bidmc.harvard.edu]; Assistant Editor(s)-In-Chief: Kristin Feeney, B.S. [mailto:kfeeney@perfuse.org]

Overview
Tetralogy of Fallot is treated on two levels: with immediate emergency care for hypoxic or "tet" spells and with corrective surgery.

Emergency management of tet spells
Consequential acute hypoxia may be treated with beta-blockers such as propranolol, but acute episodes may require rapid intervention with morphine to reduce ventilatory drive and phenylephrine to increase blood pressure. Oxygen is ineffective in treating hypoxic spells because the underlying problem is lack of blood flow through the pulmonary circuit and not alveolar oxygenation. There are also simple procedures such as the knee-chest position which increases aortic wave reflection, increasing pressure on the left side of the heart, decreasing the right to left shunt thus decreasing the amount of deoxygenated blood entering the systemic circulation.