DORV, Epstein Anomaly, and TOF | Baamboozle - Baamboozle

0%

0 0 0

TOF: Pulmonary blood flow is dependent on?

PDA and or MAPCAS.

TOF: If SVR increases (squatting, knees-to-chest, pain-induced vasoconstriction), it becomes more difficult for blood to

enter the aorta, Qs decreases while Qp increases. PBF improves.

Everything we see at the bedside comes from how blood chooses the path of ___ ___ through these structures

least resistance

What is a tet spell?

an episode of acute, severe right-to-left shunting

TOF: what happens if the atrial septum is intact?

No RA -> LA decompression, no back-up mixing route. Qp/Qs becomes dependant on RVOTO & SVR. Sm. changes in preload, afterload, or PVR = desat + cardiac output

TOF: Are they ductal dependent? If so, why?

Depends: Pulm atresia/ severe pulm stenosis=RVOTO, and needs PDA

In TOF: blood exiting the RV must choose between (2):

1. Pulmonary circulation (thru narrowed RVOT) or 2. Systemic circulation (across VSD into the overriding aorta)

How do we resolve a Tet spell?

Increase SVR: knees to chest (inc. SVR), vasoconstrictors (vaso/phenyl), & sedation

TOF: If SVR decreases, it becomes easier for blood to flow...?

into the aorta. Qs improves. More blood is shunted to the right --> left across the VSD. Qp decreases. Oxygenation worsens. Tet spell!

Tetrology of Fallot has 4 linked problems:

RVOT obstruction (PS/PA), VSD, overriding aorta (over RV), RV hypertrophy https://upload.medbullets.com/topic/120002/images/tof-updated.jpg