四部曲 of 从医

迹象 & 症状

这种情况的四种缺陷特征包括:

• An abnormal opening in the wall separating the ventricles called a ventricular septal defect (VSD) that allows blood to go directly from the right to left ventricle without going through the lungs.
• A narrowing of pulmonary valve or below the valve called pulmonary stenosis that partially blocks blood flow to the lungs.
• An overly muscular right ventricle, also called right ventricular hypertrophy.
• 主动脉移位, 也被称为覆盖主动脉或Ao, 就在心室之间的异常开口上.

患有四联症的婴儿在出生时或出生后不久是蓝色的, 并且有可检测到的心脏杂音, 心跳时额外的声音. Activity such as crying may exacerbate the condition and babies may have shortness of breath or may faint. Babies also may experience a "tetralogy spell" in which oxygen levels drop suddenly leading to irritability and then sleepiness or unresponsiveness.

Most adults with tetralogy of 从医 have had surgery during childhood. The adult with unrepaired tetralogy usually has milder cyanosis and a heart murmur or extra heart sound.

诊断。

A complete cardiac evaluation for tetralogy of 从医 will include:

• Echocardiography, in which a picture is made of the heart by using sound waves
• 胸部x光片
• Electrocardiogram (EKG or ECG), which records the heart's electrical activity
• 动脉血氧含量的检查. This is usually done with an oximeter, a little light that can be placed on a finger. 有时, a blood sample may be drawn from an artery in the wrist and checked for content of oxygen, 二氧化碳和酸度.

治疗

The defects usually are corrected during a single operation done when the baby is about 6 months old unless the baby has inadequate oxygen. If the baby is too small, there may be two surgical procedures. The first procedure connects the pulmonary arteries to the aorta or its branches by a tube called a shunt to supply blood to the lungs. Later surgery enlarges the pulmonary valve opening and closes the ventricular septal defect (VSD) with a patch so that blood flows easily into the pulmonary artery and lungs. 然后取出分流器.

Most people with tetralogy have had corrective surgery by the time they reach their teens. 如果他们只放置分流器, they probably will need to have a complete repair including shunt removal.

Adult patients with tetralogy of 从医 should be seen by a cardiologist specializing in the care of adults with congenital heart disease to monitor for late complications. All patients will need to take antibiotics during subsequent surgeries or dental procedures to protect against endocarditis. They also need to be monitored regularly for any subsequent complications or heart rhythm disturbances. The most common late complication is a leaky pulmonic valve, 叫做肺反流, 这可能需要后续手术. 不过, most patients will lead relatively normal lives and women with repaired tetralogy of 从医 can have successful pregnancies.