What are cyanotic spells (Tet spells)?

What are cyanotic spells (Tet spells)?

കുട്ടികളിൽ സയനോട്ടിക് സ്പെല്ലുകൾ (ടെറ്റ് സ്പെല്ലുകൾ)

बच्चों में सयनोटिक स्पेल्स (टेट स्पेल्स)

Cyanosis is bluish discoloration of skin and lips due to decreased oxygen content of blood. It is an important feature of a group of birth defects of the heart known as cyanotic congenital heart disease. Cyanotic spells are episodes of worsening of cyanosis in infants with certain types of cyanotic congenital heart diseases with low blood flow to the lungs. Most important birth defect in this group is tetralogy of Fallot, with a combination of four defects. Hence cyanotic spells have also been called as Tet spells.

Cyanotic spells are associated with rapid breathing and may lead to loss of consciousness and even seizures due to the low blood oxygen content if the episodes are prolonged. Tet spells are usually brought on by crying or other forms of exertion.

Immediate first aid for baby with cyanotic spell is placing the baby in knee chest position. This compresses the blood vessels in the groin and decreases return of oxygen poor blood from the legs. Consequently an increase in oxygen levels of blood in other parts of the body can occur, improving the cyanotic spell. In the hospital, administration of oxygen, sedation and other medications to treat the spell will be given.

Those with recurrent cyanotic spells will need an initial operation connecting the arm blood vessel to the pulmonary artery known as modified Blalock-Taussig shunt (BT shunt). Pulmonary artery is the blood vessel taking blood to the lungs for oxygenation. Later final repair of the birth defect will be done. In advanced centers, direct repair of the birth defect may be done without resorting to a temporary BT shunt.

As worsening of cyanosis in cyanotic spells is due to transient worsening of obstruction to the blood flow to the lungs, insertion of a metallic spring like support called stent in the obstructed region is another option. This procedure can be done using small tubes known as balloon catheters introduced through the blood vessels of the groin.