Is your baby suddenly turning blue? It could be Tetralogy of Fallot.

Have you ever been scared when your little one suddenly turns blue? Or does he have difficulty breathing while breastfeeding, crying, or turning over? It's normal for any mother or father to be scared when seeing things like this. Today we're talking about Tetralogy of Fallot , a congenital heart condition that can cause symptoms like these. Although the name may sound a bit complicated, let's explain it simply.

What exactly is Tetralogy of Fallot?

Simply put, Tetralogy of Fallot is a combination of four heart defects that are present at birth. It is also called a congenital heart condition. It is a problem that occurs during the development of the heart while the baby is growing in the womb. This causes the oxygen-rich blood (red blood) to mix with the oxygen-poor blood (blue blood). This mixed blood is then pumped by the heart to the body. As a result, the organs in the body do not get enough oxygen. In medicine, we call this condition hypoxemia . To understand this better, let's take a look at how a healthy heart works.

How a healthy heart works

Imagine that our heart is like a four-chambered house. There are two chambers on the upper floor (atria) and two large chambers on the lower floor (ventricles). There are valves between these chambers, like doors. The right and left sides of the heart are separated by a wall (septum). 1. Right side: The body's oxygen-poor, blue blood enters the right atrium through the superior vena cava and inferior vena cava. 2. From there, the blood passes through a valve (tricuspid valve) into the right ventricle. 3. From the right ventricle, this blue blood is pumped through another valve (pulmonic valve) into the main vein (pulmonary artery) that goes to the lungs. 4. Inside the lungs: This blood is newly oxygenated, becoming pure red blood. 5. Left side: This oxygen-rich red blood returns to the left atrium of the heart. 6. From there, it passes through a valve (mitral valve) into the left ventricle. 7. Finally, this pure red blood from the left ventricle is pumped through the body's largest artery (aorta) to the entire body. This is how our organs get the oxygen they need to survive.

The four defects that occur in Tetralogy of Fallot (The "Tetralogy")

In the heart of a baby with Tetralogy of Fallot, there are four main defects that alter the normal process we have discussed.

What causes this condition?

The exact cause of this is not yet known. It is a defect that occurs when the heart parts are forming early in the baby's development in the womb. It is not your fault, nor is it something you did during pregnancy. So don't feel guilty about it.

Does your baby have these symptoms too?

Most children with Tetralogy of Fallot show symptoms within the first year of life.

• Blueness (Cyanosis):This is the main symptom. The baby's lips, tongue, skin, and nails take on a bluish or purplish color.
• "Tet Spells / Hypercyanosis": This is a very important thing. When a baby cries, drinks milk, tries to go to the toilet, or wakes up in the morning, they may suddenly turn a deep blue color, have difficulty breathing, and become very restless. Sometimes they may even lose consciousness. This condition can last from a few minutes to several hours.
• Difficulty breathing : The baby quickly gets tired and falls asleep after running around and playing for a while.
• Squatting: When a toddler is tired from playing, they will suddenly sit down with their knees pulled up to their chest (squatting). This unconsciously increases the amount of blood going to their lungs, making it easier to breathe .
• Growth failure: The baby's weight gain , growth, and development may be slower than other children.

When should you seek medical advice?

Don't miss your baby's monthly clinic. The doctor can detect these conditions when examining your baby. If you have any of the following symptoms, see a doctor immediately.

• If the baby's skin and lips turn blue.
• If you have difficulty breathing .
• If you are tired while breastfeeding or crying.
• If you feel like your growth is slowing down.

In the event of the following emergencies, immediately take the person to the nearest hospital Emergency Department (ETU):

• Tet Spell
• It's very difficult to breathe.
• Seizures
• Fainting
• Excessive fatigue or weakness

How is the disease diagnosed? (Tests and Diagnosis)

Your doctor will examine the baby, listen to the heartbeat, and if there is any doubt, refer you for several tests.

• Chest X-ray: This looks at the shape of the heart. In Tetralogy of Fallot, the heart may appear "boot-shaped" because the right ventricle is enlarged.
• Electrocardiogram ( ECG ): A painless test that measures the electrical activity of the heart.
• Echocardiogram (Echo):This is the most important and accurate test. It is like a scan. It can clearly see everything in the heart, such as the chambers, valves, holes ( VSD ), and narrowing (PS).
• Cardiac Catheterization: In some cases, this test is done before surgery to measure heart pressure and oxygen levels, and to look closely at the structure of the veins. In this test, a small tube is passed through a vein in the groin to the heart.

What are the treatments?

The only permanent treatment for Tetralogy of Fallot is surgery .

What do you do if you get a "Tet Spell"?

If your baby suddenly turns very blue, it is very important to stay calm . 1. Place the baby on his or her back, with the knees pulled to the chest (knee-to-chest position) . 2. Take the baby to the hospital immediately. At the hospital, the baby will be given oxygen and medication such as propranolol to control "tet spells".

Surgery

The timing of surgery depends on the severity of the baby's symptoms. Surgery is usually performed within the first two years of life.

• Palliative Surgery (Blalock-Taussig shunt): Some babies are very small or weak and may not be able to withstand the full surgery. In such cases, a small tube-like connection is made between an artery in the body and an artery in the lung to increase the amount of blood going to the lungs. This can help the baby get a little bigger and stronger.
• Total Corrective Surgery: In this, the hole in the heart (VSD) is closed with a patch, and the narrowed passageway to the lungs (PS) is widened. After this surgery, blood flow in the heart returns to normal.

With the advancement of medical technology today, this surgery is very successful.

After surgery...

After successful surgery, most children can live a normal life without any symptoms or limitations. They can go to school, play, work in the future, and get married. However, even after surgery, it is essential to have regular follow-up with a doctor throughout their lives. Sometimes, changes in heart rhythm (arrhythmias) can occur, so it is important to have regular check-ups. tetralogy of fallot, heart disease, pediatrics, blue baby, cyanosis, tet spells, birth defects, congenital heart defect, hole in the heart, VSD