RT Book, Section
A1 Bashore, Thomas M.
A1 Granger, Christopher B.
A1 Jackson, Kevin P.
A1 Patel, Manesh R.
A2 Papadakis, Maxine A.
A2 McPhee, Stephen J.
A2 Rabow, Michael W.
SR Print(0)
ID 1166611125
T1 Tetralogy of Fallot
T2 Current Medical Diagnosis and Treatment 2020
YR 2020
FD 2020
PB McGraw-Hill Education
PP New York, NY
SN 9781260455281
LK accessmedicine.mhmedical.com/content.aspx?aid=1166611125
RD 2021/03/01
AB ESSENTIALS  OF  DIAGNOSISFive  features  are  characteristic:–  VSD.–  Concentric  RVH.–  RV  outflow  obstruction  due  to  infundibular  stenosis.–  Overriding  aorta  in  half  (requires  less  than  50%  of  the  aorta  to  override  the  septum).–  A  right-sided  aortic  arch  in  25%.Most  adult  patients  with  tetralogy  of  Fallot  have  been  operated  on,  usually  with  an  RV  outflow  patch  and  VSD  closure.Physical  examination  may  be  deceptive  after  classic  tetralogy  repair,  with  severe  pulmonary  valve  regurgitation  often  present  if  a  transannular  patch  was  used.Echocardiography/Doppler  may  underestimate  significant  pulmonary  valve  regurgitation.  Be  wary  if  the  RV  is  enlarged.Arrhythmias  are  common;  periodic  ambulatory  monitoring  is  recommended.Serious  arrhythmias  and  sudden  death  may  occur  if  the  QRS  is  wide  or  the  RV  becomes  quite  large,  or  both.