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Postural effects in tetralogy of fallot

1953; Elsevier BV; Volume: 15; Issue: 3 Linguagem: Inglês

10.1016/0002-9343(53)90083-7

1555-7162

Paul R. Lurie,

Pulmonary Hypertension Research and Treatments

The postural effects upon cyanosis and dyspnea in tetralogy of Fallot, including the beneficial effects of squatting, the knee-chest and other positions, and the disadvantageous effect of standing are shown to be directly due to alterations in volume of venous return with consequent change in the oxygen saturation of mixed venous blood. Speculations are adduced to explain the peculiarly marked effect of altered venous return in malformations when there is venoarterial shunt, reduced pulmonary blood flow coexisting with high systemic flow and absence of a tendency to go into congestive heart failure. Diagnostically, these postural effects are important when they can be demonstrated in the form of simple clinical tests. A patient demonstrating them will respond well to systemic-pulmonary anastomosis. Therapeutically, they are of real importance in carrying a patient through the period of waiting for definitive surgery.