What Is The Prognosis Of Fallot Complex With Severe Mental And Growth Retardation
- The prognosis of Fallot Complex with Severe Mental and Growth Retardation is dependent upon the severity of the signs and symptoms and associated complications, if any
- Individuals with mild conditions have better prognosis than those with severe symptoms and complications
- Typically, the prognosis may be assessed on a case-by-case basis
Filing For Social Security Disability With Pulmonary Atresia
If you are the parent or guardian of a child born with Pulmonary Atresia, it may be helpful to know that your child automatically qualifies for Social Security Disability benefits, because PA has been determined by the SSA to meet the guidelines for a Compassionate Allowance. In spite of that fact, you would do well to have your case evaluated by a Social Security Disability attorney.
While the approval process has been streamlined for qualifying conditions, it is still of the utmost importance that the application paperwork be complete and accurate. An experienced disability attorney can help you avoid the common mistakes that could result in a delay of your claim.
Tetralogy Of Fallot Treatment
Surgery is the only treatment for tetralogy of Fallot.
Surgery most often occurs between the ages of 18 and 36 months and consists of relieving the narrowing of the pulmonary valve, enlarging the main artery that carries blood to the lungs, and closing the hole between the bottom chambers of the heart .
Some babies who are not yet ready for intracardiac repair surgery may have a temporary procedure in which a bypass between the aorta and pulmonary artery is created. Later, when the child has a complete repair, the bypass is removed.
There are several ways to treat the pulmonary valve stenosis malformation of tetralogy of Fallot including:
- Pulmonary valvotomy the valve and surrounding tissue is removed which results in leakage. Many patients will require pulmonary valve replacement in late adolescence/early adulthood.
- Conduit/homograft placement a pulmonary valve and main pulmonary artery replacement. As patients get older they may outgrow conduits. Conduits can also age and get calcium buildup. Either of these may require surgical repair.
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What Can Be Done About Tetralogy Of Fallot
Tetralogy of Fallot is treated with two kinds of surgery. One provides temporary improvement by a shunt to give more blood flow to the lungs. The other is a complete repair of the two most important abnormalities that make up tetralogy of Fallot. Patients might have one or both surgeries in their lifetime.
Shunt Operation
In some patients, a shunt operation may be done first to provide more blood flow to the lungs. This is not open-heart surgery and doesn’t fix the inside of the heart. The shunt is usually a small tube of synthetic material sewn between a body artery and the pulmonary artery. The shunt is removed when a complete intracardiac repair is done later. This is usually done in babies to allow them grow big enough to have a full repair but is occasionally done in adults if a complete repair isn’t an immediate option. Some adults had shunts as children, but never got a complete repair. Those patients may still be able to get a complete repair, even as adults.
Complete Repair
Repeat Operations
Survival And Causes Of Late Death
Although previous palliative procedures were associated with increased operative mortality , there were no differences in survival between operative survivors who had had a palliative procedure prior to the Fallot repair and those who received the repair as the primary operation . Sixteen patients had died between discharge and follow-up . The causes of death were all cardiac, seven were sudden deaths probably related to arrhythmias. The time and causes of death are presented in . Three patients died early following the reoperation and another three died late.
Causes of late death after Tetralogy of Fallot repair. The interval from the repair and the patients age at death are indicated.
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Heart Disease Categories Groups A B And C
Inclusion of cardiac diseases in the HDC Gr A, B, and C is based on hemodynamic significance, type of HD, natural history, amenability to intervention, and overall outcome . HDC Gr A, B, and C would contribute an entry score of 5, 10, and 20 respectively. In many cases, a detailed diagnosis can foretell the perspective functional capacity. For example, a small PFO would be included in the HDC Gr A which suggests no or mild disability but PFO with cryptogenic syncope would qualify for HDC Gr B . The natural history of any HD is predictable to a large extent unless an acquired factor like bacterial endocarditis superimposes to change the natural history of a HD . The interventions are also important modifier of natural history of a HD, and are expected to improve the FC of a patient but rarely they may fail to yeild good results.
Risk Factors For Tetralogy Of Fallot
The aetiology of congenital heart defects is not understood but several factors are known to be associated:
- Maternal drug abuse, alcohol abuse and radiation exposure.
- Maternal infection during pregnancy particularly rubella and some other viral illnesses
- Genetic abnormalities.
- Poor nutrition during pregnancy
- A parent who has tetralogy of Fallot
Heredity may play a role in causing tetralogy of Fallot. An adult who has tetralogy of Fallot may be more likely than other people to have a baby with the condition.
Children who have certain genetic disorders, such as Down syndrome and DiGeorge syndrome, often have congenital heart defects, including tetralogy of Fallot.
Researchers continue to search for the causes of tetralogy of Fallot and other congenital heart defects.
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What Are The Symptoms Of Tetralogy Of Fallot
The following are the most common symptoms of tetralogy of Fallot. However, each child may experience symptoms differently.
- Because large amounts of oxygen-poor blood can flow to the body under certain circumstances, one of the symptoms of tetralogy of Fallot is blueness that occurs with such activity as crying or feeding.
- Some babies do not have noticeable cyanosis , but may instead be very irritable or lethargic due to a reduced amount of oxygen in the bloodstream.
- Some children become pale or ashen in color, and may have cool, clammy skin.
Any of these can be symptoms of tetralogy of Fallot. The TOF symptoms may resemble other medical conditions or heart problems. If you identify any of these symptoms, consult the childs doctor for a proper diagnosis.
When To See A Doctor
Seek medical help if you notice that your baby has the following signs or symptoms:
- Difficulty breathing
- Bluish discoloration of the skin
- Passing out or seizures
- Weakness
- Unusual irritability
If your baby becomes blue , place your baby on his or her side and pull your baby’s knees up to his or her chest. This helps increase blood flow to the lungs. Call 911 or your local emergency number immediately.
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How Is Tetralogy Of Fallot Diagnosed
Doctors diagnose tetralogy of Fallot based on a baby’s signs and symptoms, a physical exam, and the results from tests and procedures.
Signs and symptoms of the heart defect usually occur during the first weeks of life. Your infant’s doctor may notice signs or symptoms during a routine checkup. Some parents also notice cyanosis or poor feeding and bring the baby to the doctor.
What Are The 4 Subgroups Of Tetralogy Of Fallot
Nomenclature and Classification. The following 4 diagnostic subgroups of tetralogy of Fallot are described: tetralogy of Fallot with absent pulmonary valve syndrome tetralogy of Fallot with common atrioventricular canal tetralogy of Fallot with pulmonary atresia and tetralogy of Fallot with pulmonary stenosis.
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Living With Tetralogy Of Fallot
After surgery, your child may become tired easily and sleep more. Eventually, most children are able to be active. Childrens activity levels, appetite, and growth become normal soon after surgery. But some children who had surgery for TOF can have problems learning or growing normally.
Your child’s heart doctor may give them antibiotics to prevent infections after leaving the hospital. Your child may also need medicine before other surgeries or dental tests.
Most children who have surgery for this condition will live healthy lives. They may need more surgeries throughout their lives. One might be a pulmonary valve replacement surgery when they are adults. This will help prevent heart complications. These include enlargement of the right ventricle, abnormal heart rhythms, and heart failure. Women who want to have children should be checked by a heart doctor before they get pregnant.
Ask your child’s healthcare provider about your childs outlook.
The Diagnosis: Tetralogy Of Fallot
A maternal-fetal medicine specialist near their home in Lancaster, PA, diagnosed Maria’s unborn baby with tetralogy of Fallot , a congenital heart defect that refers to a combination of related heart defects, including a ventricular septal defect , a hole between the lower chambers, and other irregularities such as pulmonary stenosis, a narrowing of the pulmonary valve that affects blood flow from the heart to the lungs.
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Cardiovascular Diseases In Adultscoronary Artery Disease In India
CAD is emerging as the significant cause of morbidity and hampered productivity and substantial mortality amongst the adult population . Prabhakaran et al. analyzed data from three large prospective studies done in India and compared it with GBDS, 2010. They found higher death proportion attributable to CVD and an age-standardized CVD-related death rate . Indian data from GBDS revealed gender-wise percentage of total deaths and DALYs due to CVD and its components . The prevalence of CVD as a whole and ischemic heart diseases times) was 1.3 and 1.6 times higher than the global average, respectively . Figure 3 shows state-wise prevalence of CVD , ischemic heart disease , stroke , and RHD . The authors classified states into four ETL groups based on the ratio of DALYs of communicable and non-communicable diseases as follows: high , higher-middle , lower-middle , lower . The study documented that CVD prevalence was highest in the high ETL state group , followed by the higher-middle ETL state group . The study also found a high prevalence of a gamut of risk factors like dietary risks , high SBP , high total cholesterol , high fasting plasma glucose , and high BMI , as well as tobacco use, less use of fresh fruits, and pollutions. Prevalence of mutation of specific genes can also be partly responsible for this epidemiological shift .
How Long Can You Live With Tetralogy Of Fallot
Tetralogy of Fallot is a rather common complex cardiac malformation with an incidence of 0.1/1000 live births. Without surgical intervention, patients had a 1 year survival rate of 66%, 49% after 2 years and only 1015% after more than 20 years .
Does Tetralogy of Fallot qualify for disability? You can get disability benefits if you have congenital heart disease that causes cyanosis or severe functional limitations on your ability to work. If your type of congenital heart disease is so severe that you are unable to work, you may be able to get disability benefits from Social Security .
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What Your Rfc Should Include
An RFC for congenital heart disease should state your specific limits on how long you can walk, sit, and stand, and whether you can push, pull, and carry. And because congenital heart disease can cause significant fatigue it is extremely important that your doctor note whether you need to rest or lie down throughout the day. Often, the need for frequent and unscheduled breaks precludes regular employment, so your doctor should state that because of your congenital heart disease you will be required to rest frequently . Your doctor should also note if your congenital heart disease would cause you to miss work on a regular basis, as this would affect your productivity. A reduction of productivity of 20% ordinarily results in an approval for disability.
Direct And Indirect Microeconomic Effects Of A Heart Disease On Affected Families Leading To Debt
Management of cardiac diseases is usually self-financed by the family resulting in catastrophic health spending .
The microeconomic impact of cardiac surgery on the families of patients with CHD was evaluated 81% of the families struggled financially and went for distress financing, 4% had health insurance, while 10% were affordable . Even in the post-operative period, 56% of the families needed to change their lifestyle to accommodate the financial burden .
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Congenital Heart Disease Listing Requirements
The listing requirements for symptomatic congenital heart disease is set forth in Listing 4.06 and covers both cyanotic and acyanotic diseases. To be approved under Listing 4.06, you first must be diagnosed with congenital heart disease by cardiac catheterization or another established test. You must also experience one of the following three complications:
- Cyanosis at rest, and one of the following:
- Hematocrit of at least 55%, or
- Oxygen saturation of less than 90% in room air or resting plasma oxygenation of 60 Torr or less.
These listing requirements are particularly complex ask your doctor to determine whether you meet the criteria for this listing .
What To Expect From Your Doctor
Your or your child’s doctor is likely to ask you a number of questions, such as:
- When did you first notice symptoms?
- Do the symptoms occur all the time or do they come and go ?
- Does anything seem to improve your or your child’s symptoms?
- What, if anything, makes the symptoms worse?
- How are you or your child eating and sleeping?
- Have you noticed fainting spells or episodes when your or your child’s lips and skin become more blue or dusky?
- Are you or your child vomiting or losing weight?
- Have you or your child had heart racing, breathlessness or leg swelling?
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Tetralogy Of Fallot Causes
Tetralogy of Fallot occurs during fetal development. Most of the time the cause is unknown, but factors that may play a role include:
- Poor nutrition
- Maternal alcoholism
- A parent with the condition
Tetralogy of Fallot may also be associated with DiGeorge Syndrome which is caused by a chromosomal abnormality.
Delivery Day In The Sdu
Aidan was delivered at 9:30 a.m. on Feb. 15, 2010. Babies born in the SDU are tended to by a highly specialized team of obstetricians, anesthesiologists, neonatologists, cardiologists, advanced practice nurses, OB and neonatal nurses and social workers. Mother and baby have immediate access to a level of skill and technology that is among the highest in the world.
Delivering at CHOP gave us confidence, Maria recalls. We knew that whatever care the baby needed would be close by.
After he was delivered, Maria and Charles were able to touch Aidan before a team took him to an adjacent room to stabilize him. At 4 p.m., Maria was able to visit her son in the Tabas Family Cardiac Intensive Care Unit down the hall.
I was able to hold him, she recalls. He had wires and things but the nurses made it work. Theyre wonderful. We shed a lot of tears.
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Functional Capacity In Cardiovascular Disorders And Cardiac Disability
As discussed before, the cardiac ailments are ordained to have changeable waxing-waning functional abilities . Therefore, cardiac disability criteria cannot be a single point assessment. Uncorrected heart diseases are usually associated with pressure/volume overload, unbalanced pulmonary and systemic blood flow ratio, cyanosis, PAH, and myocardial ischemia. The ensuing irreversible myocardial damage terminates into intractable arrhythmia, congestive heart failure and systemic hypoxia, increasing the risk of any intervention. The combined cardiopulmonary dysfunction in these patients limits the capacity to initiate, sustain, or complete even routine activities. Up to 25% of complex CHDs may present with HF in adulthood . The operated patients may also have suboptimal FC in the presence of residual defects, ventricular dysfunction, chronotropic incompetence, tachyarrhythmia, heart block, SAH, PAH, PVH, prosthesis implantation, post-cardiac transplant deconditioning, IE, and co-existing multi-organ dysfunction . These patients need to undergo evaluation of cardiac disability based on a scoring system utilizing existing subjective and objective parameters, for the assessment of functional capacity .
Qualifying For Disability Because Of Reduced Functional Capacity
Many adults have serious heart conditions that make it difficult for them to work, but they don’t meet the stringent requirements of the SSA’s impairment listings above. For instance, maybe you have coronary artery disease and had one ischemic episode in the past year but not three. Or maybe you have systolic heart failure but your ejection fraction is 40%, not 30%, and the results of your exercise test is poor but not as bad as the SSA requires.
You still may be eligible for disability benefits . When you don’t automatically qualify for disability benefits under the SSA’s official listings, as the next part of the disability determination process, the SSA is required to consider the effect of your heart condition on your capacity to perform routine daily activities and work. The SSA will then determine whether there is any kind of job you can safely be expected to do.
What Is Your Residual Functional Capacity ?
If you have had an episode of heart failure or ischemia, or you have shortness of breath, exhaustion, or angina when you do physical work, the SSA should give you a rating of the type of work it thinks you can do. This is called your residual functional capacity . The SSA will consider your lab tests, your exercise tests, your imaging tests, and your doctor’s notes on your functional limitations and restrictions, as well as your reports of angina and other symptoms.
What Jobs Can You Do With Your RFC?
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