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Old 09-20-2011
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Default Doubt In Tetralogy of Fallot?

Can anybody explain the rationale of giving beta blockers during a tet spell??
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Old 09-20-2011
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Originally Posted by bassatom View Post
Can anybody explain the rationale of giving beta blockers during a tet spell??

Main focus in tet spell is to produce pulmonary vasodilation--by o2

Decrease rt ventricular obstruction and decrease rt to left shunt and relax rt ventricleand increase systemic resistence -->done by betablocker.
also betablocker reduces infundibular muscle spasm also helps in relieveing obstruction and also abolish hyperpnea .

also phenylephrine, iv fluids , ketamine are given to increase SVR.

Last edited by Ace3; 09-20-2011 at 11:58 AM.
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Old 09-20-2011
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Can anybody explain the rationale of giving beta blockers during a tet spell??
In TOF, when blood comes in rv from ra, it can either go into pulmonary circulation, or it can go into lv via shunt..if the pulmonary resistance is high blood flows into the path of least resistance n goes into LV...as a result cyanosis occurs
in tet spell, child cries etc, pul resistance goes up,...n right to left shunt starts...leading to deoxygenation...

Reversal is achieved by increasing systemic resistance, more than that in pulmonary circulation...!!
1st basic maueuver used is squatting, that increases systemic resistance,..n similarly b, blockers r given, which cause vasoconstriction n increase systemic resistance...!! now blood cannot cum into lv as it is offers more resistance, n thus has to go to pulmonary circulation...child gets oxygenated
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