Page 162 - Clinical Pearls in Cardiology

150 Clinical Pearls in Cardiology

more blood is diverted to the lungs and gets oxygenated.
So more oxygenated blood enters the left ventricle
from the lungs, and is then pumped into the systemic
circulation. This reduces the cyanosis and improves
dyspnea in a person with Fallot’s tetralogy. So squatting
after exertion is commonly seen in Fallot’s tetralogy.

Fig. 4: Blood circulation in tetralogy of Fallot

17. What are the complications seen in adults with
tetralogy of Fallot?
The complications in adult patients with tetralogy of
Fallot include progressive dyspnea, chronic cyanosis,
gout, secondary erythrocytosis with hyperviscosity
symptoms, abnormalities of hemostasis, cerebral
abscesses, stroke and endocarditis. Cyanotic spells
usually do not occur in adolescents or adults.
18. What are the peculiarities of the fetal circulation?
In the fetus, oxygenated blood comes from the placenta
through the umbilical vein and it enters the inferior