Tetralogy of fallot

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Sections available in full article Introduction, Presenting signs, Acute presentation, Age predisposition, Special risks (e.g. anesthetic), Pathogenesis, Etiology, Predisposing factors, Pathophysiology, Timecourse (incubation, duration), Diagnosis, Presenting problems, Client history, Clinical signs, Diagnostic investigation, Confirmation of diagnosis, Gross autopsy findings, Differential diagnosis, Treatment, Standard treatment, Prevention, Control, Sequelae, Prognosis, Expected response to treatment, Reasons for treatment failure, Sources, Publications, Vetstream contributor(s),
Contributors Dr Serena Brownlie BVM&S PhD CertSAC MRCVS
Dr Phil Fox DVM DipACVIM DipECVIM ACVECC
Ms Penny Watson MA VetMB CertVR DSAM DipECVIM MRCVS

Introduction

  • About 6% of feline congenital heart defects.
  • Cause : combination of defects - pulmonic stenosis, high ventricular septal defect (VSD), dextroposition/overriding aorta; plus right ventricular hypertrophy.
  • Signs : usually stunted and cyanotic.
  • Diagnosis : radiographic signs of right-sided enlargement, cardiac murmur, ultrasonography.
  • Treatment : none to medical to cardiac surgery, depends on severity.
  • Prognosis : poor to grave.

Diagnosis

Clinical signs

  • Cyanosis, affecting cranial and caudal mucosae uniformly.
  • Dyspnea and tachypnea.
  • Murmurs  Cardiac sounds: overview  - forward of left heart base (pulmonic stenosis); right sternal border (VSD).
  • Signs of right-sided congestive heart failure, eg hepatomegaly, ascites (rare).

Diagnosis

Differential diagnosis

Systolic murmurs in young cats
  • Aortic stenosis  Aortic stenosis  .
  • Atrioventricular valve dysplasia  Atrioventricular valve dysplasia  .
  • Pulmonic stenosis.
  • Ventricular septal defect (VSD)  Ventricular septal defect  .
  • Hypertrophic cardiomyopathy with dynamic left ventricular outflow tract obstruction  Heart: hypertrophic cardiomyopathy  .
  • Innocent 'flow' murmur.
  • Endocarditis  Endocarditis  .

Sequelae

Prognosis

  • Poor if mild.
  • Hopeless if severe.

Expected response to treatment

  • Exercise tolerance.
  • PCV.

Reasons for treatment failure

  • Severity of defect.
  • Thrombosis of surgically induced shunt.

Sources

Publications

Refereed papers

  • Liu S K (1977)Pathology of feline heart diseases.Vet Clin North Am7(2), 323-339.

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