MORE INFO:

• These episodes of turning blue are called “tet spells”
• These babies often turn blue (cyanotic)
• Commonly seen in Down syndrome and DiGeorge syndrome (1)
• Tetralogy of fallot involves 4 types of heart defects:
  • Pulmonary valve (and passageway) stenosis (narrowing)
  • Right ventricular hypertrophy (enlargment)
  • Ventral septal defect (hole in wall of heart)
  • Overriding aorta (aorta in wrong place)
• Usually blood in pumped from right side of heart into lungs to get oxygenated
• After oxygenated the blood goes to the left side of the heart and eventually out to the rest of the body
• In this heart defect there is a hole (VSD) between right and left side where the blood travels.
• This means that blood from right side has not gone through the lungs yet to be oxygenated.
• Surgery is usually needed to repair this defect
• Initially a temporary shunt operation may be done and later a complete repair

NCLEX TIPS: (for nursing students)

• Poor weight gain, fainting, and tiring easily are signs of tetralogy of fallot
• 2-4 months is the most common time for tet spells but can happen later (2)
• These children usually have a murmur (2, 3)
• Tet spells usually happen after crying, feeding, bowel movements
• Tet smells happen when oxygen decreases in the blood
• Children sometimes squat when they are short of breath as this increase blood to lungs (2)
• They are at increased risk for seizures, sudden death, emboli (3)