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Treatment for a Tet Spell

Tetralogy of Fallot is a heart condition that accounts for about seven percent of all congenital heart defects. It consists of four separate congenital anomalies and can cause poor growth, feeding problems, lethargy and other issues. One of the most pressing issues is the “tet spell,” in which the heart’s ability to deliver oxygen to the body is significantly compromised. Understanding tet spells will help you prevent brain damage, seizures or even death.

  1. Triggers

    • Understand the triggers of tet spells. Knowing the triggers will help you prevent the onset of tet spells until the heart anomalies can be corrected. A tet spell can be triggered by any activity that reduces oxygen saturation in the blood, such as crying, defecation, running or intense playing. Because tet spells occur most often in infants between two and four months of age, prolonged crying is the most common trigger.

    Signs

    • Know the signs of tet spells. This will help you administer preliminary treatment. A toddler will exhibit cyanosis (lack of oxygen, which results in the skin turning blue) during a tet spell. Breathing irregularities, such as deep or rapid breathing, also frequently occur. The sound of the heart murmur associated with Tetralogy of Fallot will also become more intense.

    Preliminary Treatment

    • Pull the infant’s knees up to his chest. This squatting position helps raise oxygen saturation in the blood, alleviating the effects of a tet spell. You can also take measures to calm the child, such as rocking, singing or playing soft music.

    Medication

    • Ask your doctor about medications to control tet spells. The most commonly used medications are morphine, phenylephrine, ketamine and propranolol. These medications have a sedating effect, allowing the sufferer to relax so oxygen levels can stabilize.

    Surgery

    • Consider complete repair of Tetralogy of Fallot. The reparative surgery is typically completed within the first year of life. Complete repair significantly reduces or eliminates the possibility of tet spells and substantially increases long-term survival rates. Palliative surgical methods, such as a Blalock-Taussig shunt, are effective treatments for Tetralogy of Fallot patients who are not candidates for full surgical repair.

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