Diagnosis
The ECG shows typical changes of a right-sided increase in muscle mass of the chamber. An ultrasound of the small heart shows both the defect in the cardiac septum, the crossing aorta, and the narrowing of the pulmonary arteries. The X-ray can also provide information.
Here, the typical features, such as the enlarged right ventricle, missing pulmonary arteries and the resulting reduced vascular drawing of the lung can be seen. If one wishes to depict the prevailing conditions more precisely, a heart catheter is used. A thin tube is inserted into the heart through a peripheral vein and contrast medium is injected. This procedure is performed under anesthesia in infants.
Therapy
The therapy depends on the severity of the tetralogy of Fallot. If the pulmonary arteries, which are supposed to transport the blood to the lungs, are not only narrowed, but blocked, an attempt is made to keep the embryonic connection between the aorta (main artery) and the pulmonary artery (the so-called Ductus Botalli) open with the help of medication. Prostaglandins are used here.
Prostaglandin E1 is given as an infusion. If there is a high degree of cyanosis (lack of oxygen in the blood and the organs to be supplied), the pulmonary artery can be connected to an artery that carries oxygen-rich blood into the body. This is done through a Gore-Tex tube.
Another promising method is to dilate the pulmonary artery with the help of a small balloon. The tetralogy of Fallot is corrected surgically within the first year of life. The defect of the cardiac septum is closed so that the aorta emerges from the left heart as it should normally do.
The narrowing of the pulmonary artery is corrected by removing muscle tissue. The Fallot ́schen tetralogy prevention is unfortunately not possible. Since the cause has not yet been conclusively clarified, prophylaxis is difficult.
Nowadays, however, expectant parents can make use of prenatal diagnostics. Here, by means of various methods (from ultrasound to amniotic fluid puncture), congenital malformation, especially heart defects, can be detected even before birth (med. : prenatal). It is particularly important in such a diagnosis that the birth takes place in a specially equipped hospital (e.g. university hospital or special centers). This is because not only the necessary equipment is available there, but also appropriately trained and specialized personnel.
