ANSWER:PAEDIATRIC MCQ 16:In children with Fallot’s tetralogy




16) In children with Fallot’s tetralogy


Cyanosis usually occurs 3-6 months after birth and may present in the first few years of life.
Heart failure is not generally a feature of this condition. Systolic ejection murmur is present and
the intensity is inversely proportional to the degree of Rt ventricular outflow obstruction.
Pulmonic valve closure is not heard and hence single S2. Squatting is uniquely characteristic
of a right to left shunt, and relieves cyanosis in exercise by decreasing systemic venous return.
Prolonged cyanosis causes secondary polycythaemia which increases oxygen carrying
capacity, therefore normal Hb concentration may cause symptomatic anaemia.


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