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Due to the mixing of deoxygenated and oxygenated blood in the left ventricles through the ventricular septal defect, there is a low oxygen supply to other parts of the body. This, coupled with blood flow through the aorta due to the obstruction at the pulmonary valves leads to a distribution of blood that is completely devoid of oxygen. Consequently, there is cyanosis right from birth or within the infantile stage. The patients also suffer from heart mummers ranging from impeccable to very loud mummers (Graham, Volpe, Barker, Economy & Valente, 2013).
The patient also presents with difficulty in breathing, dyspnea on exertion, retarded physical development and growth, clubbing of both toes and fingers and lastly polycythemia. Children are suffering from this condition; sometimes experience Tet spells that are as a result of the continued circulation of the desaturated blood due to the increased resistance of blood flow to the lungs. Tet spells are manifest with cyanosis, which leads to syncope and brain death or injury depending on the duration of hypoxia.
Most children squat when experience the Tet sell with increased resistance of the vessels which allows for a reversal of the shunt temporarily. There are a number of other conditions to consider while evaluating a patient suspected to be suffering from tetralogy of the fallot. Some of them include pulmonary stenosis, acute anemia, bacteremia, stenosis, cardiogenic shock, pneumothorax, pediatric pneumonia and Patent Ductus arteriosus. With delayed management of the tetralogy of the Fallot, there is hypertrophy of the right ventricle that is as a result of the resistance of the right ventricle and the ventricular septal defect.
This eventually progresses to dilated cardiomyopathy that begins with the right heart and then the left side of the heart. According to
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