Tetralogy of Fallot: Literature Review
Tetralogy of Fallot is a congenital heart defect associated with systemic cyanosis, accounting for approximately 5 to 6% of all cases of congenital heart disease and is characterized by; ventricular septal defect, aortic override, pulmonary stenosis and right ventricular hypertrophy. It is the most common cause of blue baby syndrome with children diagnosed developing Tet spells. Sudden increases in cyanosis followed by syncope characterize Tet spells and may result in hypoxic brain injury and death. Environmental and genetic disorders are other causes of TOF; always associated with chromosome 22 deletions and DiGeorge syndrome and occurs slightly more often in males than in females. If left untreated, Tetralogy of Fallot rapidly results in progressive right ventricular hypertrophy due to the increased resistance on the right ventricle. This progresses to dilated cardiomyopathy which begins in the right heart chambers often leading to left heart failure. Actuarial survival for untreated Tetralogy of Fallot is approximately 75%, 60%, 30% and 5% after the first year of life, four years, ten years, and forty years respectively.
Review of the Literature
According to Digilio, et al. (2001), Transposition of the Great Arteries (TGA) has a prevalence rate of 0.2 per 1000 live births in the United States accounting for approximately 5 to 7% of all Congenital Heart Defects (CHDs). TGA is the most frequent cyanotic CHD diagnosed in the neonatal period and genetic contribution to the pathogenesis of TGA is not considered to be strong. This is due to few familial cases identified and that genetic syndromes are uncommonly associated with TGA. The study concludes that the mean precurrence risk for CHD among siblings of patients affected with TGA is 1.4%, and TGA is not always a sporadic occurrence in these families. Familial precurrence of concordant cardiac defects within affected family members' supports monogenic or oligogenic inheritance of TGA in selected pedigrees. In addition, TGA and congenitally corrected TGA can segregate in the same family due to a probable monogenic transmission supporting a pathogenetic link between some cases of complete TGA and looping abnormalities.
In their publication, Nembhard, Salemi, Wang, Loscalzo, & Hauser (2010) argue that birth defects...
Source: http://circ.ahajournals.org/cgi/content-nw/full/111/23/e394/TBLIB Echocardiographic Features That Suggest Potential Need for Surgical Intervention Vegetation Persistent vegetation after systemic embolization Anterior mitral leaflet vegetation, particularly with size >10 mm* embolic events during first 2 wk of antimicrobial therapy* Increase in vegetation size despite appropriate antimicrobial http://circ.ahajournals.org/math/dagger.gif Valvular dysfunction Acute aortic or mitral insufficiency with signs of ventricular http://circ.ahajournals.org/math/dagger.gif Heart failure unresponsive to medical http://circ.ahajournals.org/math/dagger.gif Valve perforation or http://circ.ahajournals.org/math/dagger.gif Perivalvular extension Valvular dehiscence, rupture, or http://circ.ahajournals.org/math/dagger.gif New heart http://circ.ahajournals.org/math/dagger.gif Large abscess or extension of abscess despite appropriate
Endocarditis, a heart condition, "is an infection of the inner lining of the heart," the inner lining being the endocardium (Mayo Clinic Staff). According to the Mayo Clinic, the condition "typically occurs when bacteria or other germs from another part of [one's] body....spread through the bloodstream and attach to damaged areas in [the] heart" (Mayo Clinic Staff, 2011). Endocarditis has the ability to damage or completely destroy the heart when
Quality Development in Advanced Practice field knowledge in nursing: Proposal on Enhancing the dental health of children suffering Congenital Heart Disease One of the most prevalent development abnormalities found in children is heart disease, and it occurs in about 8-10 in every 1, 000 births. Dental supervision of children with congenital heart problems calls for special care, due to their increased susceptibility to contagious endocarditis, which is associated with bacteremia caused
The first article, Changes in Mitral Regurgitation After Replacement of the Stenotic Aortic Valve (2008) stresses a relatively large patient study of those undergoing Aortic valve replacement and then possibly experiencing mitral regurgitation (MR), a common and sometimes concerning complication that as the study shows can occur without any known mitral defect. The study is significant in that it establishes the fact that MR is not as dangerous as once
Vancomycin should be given for at least 60 minutes. The initial dosage for pediatrics with renal impairment is not less than 15 mg/kg per day or 15 times the GFR in mL/min. Premature infants should have longer dosing intervals. PO administration should be 40 mg/kg/day in 3-4 divided doses for 7-10 days. The maximum is 2,000 mg/day, which may be diluted in 1 oz of water or administered through
Clicking on the links reveals that some of the topics provide more information and information in different formats than others. For example, the Aging Driver topic lists the following clickable PDF files: Tips for Safe Driving, How to Help the Older Driver, Getting by Without Driving, Am I a Safe Driver?, and Successful Aging Tips. Other topics, such as Health Disparities, do not provide information directly but only link the user to
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