8yr/m child with h/o cyanosis since infancy,came with breathlessness and cyanosis.,giddiness. O/E: central cyanosis+,plethoric conjunctiva,clubbing+ CVS:ESM+ pulmonary area Investigation: ABG: acidosis+ CBC: polycythemia,thrombocytopenia CXR:Oligemic lung field ECG:RVH+RAD Echo: pending Provisional diagnosis:CCHD?TOF physiology (severe PS) with cyanotic spell. Discuss the management?



Pt seems in tet spell... Manage with knee chest position, oxygen, morphine, propanolol, soda bicarb. Correct polycythemia with partial exchange or phlebotomy, proper hydration. Stabilize pt then plan for surgery...

ToF with cyanotic spells. Chest knee position. Correction of acidosis with soda bicarb. Propanolol,proper hydration. Later surgery

8 yr dx TETRALOGY OF FALLOT with complications set already RIGHT HEART FAILURE POLYCYTHEMIA Probably gout Treat all these reg TOF correction take a cardiologist opinion

Yes TOF. It somewhat delayed diagnosis. Surgical correction to be tried fairly early. However here it may be tried gradually and in phase manner. Otherwise the result will likely to be unfavorable.Once damage to the system occur any corrections may be futile.

Cchd r/0 ps Do erythropeotin if less confirm ps Rbc count raised Cardiomegaly with clubbing with cynosis Tall p wave in favor rt atrial enlargement or ph Waiting for 2 d report ideal 3 d

Echo: CCHD/TOF/Severe Valvular and infundibular PS/Large VSD/Over riding of aorta

plz update with ur final Rx charting and response...

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Straight forward Pt of TOF in Hyper cyanotic spell Definitive Rx surgical correction after stabilisation.

Clubbing of fingers in Bronchectasis . In clubbing of fingers the tissues at base of the nail are thickened and the angle between the nail base and adjacent skin of the finger is obliterated . * The nail looses it's longitudinal ridges from side to side and above down words . * pulmonary tuberculosis and empaema and pleural effusions .

I agree with Dr. Manish Verma & Dr.Anoop Modi. stabilise pt. ( canonical spells)

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