Case Report: Supervisor: Dr. Tina Christina Tobing , Sp. A (k) Medan, 21 Desember 2012

CASE REPORT

TETRALOGY OF FALLOT (TOF) Presented by: Ardiana Annisa Dira Wahyuni Siregar

Supervisor : dr. Tina Christina Tobing , Sp. A (K)

Medan, 21 Desember 2012 DEPARTEMENT OF PEDIATRICS H. ADAM MALIK GENERAL HOSPITAL FACULTY OF MEDICINE SUMATERA UTARA UNIVERSITY MEDAN 2012

Definition • Tetralogy of Fallot is cardiac malformation comprising ventricular septal defect (VSD), right ventricular outflow tract obstruction(infundibular stenosis),aorta overriding the intervertricular septum, and right ventricular hypertrophy.

Etiology • The etiology of TOF is heterogeneous and includes both environmental and genetic factors that most likely interact with one another in certain cases. Several environmental teratogens have been shown specifically to increase the risk of developing TOF with PS, including maternal diabetes,retinoic acids, maternal phenylketonuria (PKU), and trimethadione.

Clinical Manifestasion • • • •

Cyanosis Hipercyanotic spell Clubbing finger Murmur

Diagnosis • • • •

Chest radiography Electrocardiogram Echocardiography Cardiac catheterization

Chest radiography

Differential Diagnosis • Ebstein’s malformation • Tricuspid atresia • TGA

Treatment • Medical treatment • Surgical : palliative surgical corrective surgical

Prognosis • Without surgical intervention, around 50% of children with TOF will die within the first few years of life and survival beyond 30 years without surgery is uncommon. With corrective surgery in childhood, survival to discharge from hospital is 95-99%, and almost all children can be expected to survive to adulthood.