{"id":12891,"date":"2014-07-28T13:37:47","date_gmt":"2014-07-28T13:37:47","guid":{"rendered":"http:\/\/cardiophile.org\/?p=12891"},"modified":"2021-10-29T06:50:11","modified_gmt":"2021-10-29T01:20:11","slug":"tetralogy-of-fallot-with-flap-valve-vsd","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/tetralogy-of-fallot-with-flap-valve-vsd\/","title":{"rendered":"Tetralogy of Fallot with flap valve VSD"},"content":{"rendered":"<p><iframe loading=\"lazy\" title=\"YouTube video player\" src=\"https:\/\/www.youtube.com\/embed\/GznZJnh0Hak\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<h2><span style=\"color: #008000;\">Tetralogy of Fallot with flap valve VSD<\/span><\/h2>\n<p>In Tetralogy of Fallot with flap valve VSD, there is a flap attached to the ventricular septal defect (VSD) which will restrict the flow across the VSD and can cause supra systemic right ventricular pressure. Usually right ventricular pressure is just systemic in Tetralogy of Fallot because the large unrestrictive VSD equalizes the pressures in the two ventricles.<\/p>\n<p>P R Kumar, A D Rakshak, P Rajagopal, T N Padmanabhan, D S Rao, S Jaishanker reported five cases of TOF with flap valve VSD [1]. TOF with restrictive VSD and suprasystemic right ventricular pressure has a high mortality rate. In all of their 5 cases, accessory or excessive tricuspid valve tissue obstructed the ventricular septal defect. Early recognition is important because of the poor prognosis.<\/p>\n<p>In these cases with restrictive VSD, right ventricular systolic pressure shows post ectopic potentiation and ventricular pressure trace shows characteristic &#8216;isosceles triangle pattern&#8217; [2]. This is in contrast to the rectangular shape seen in those with non-restrictive ventricular septal defect [3]. Post ectopic potentiation is not seen in usual TOF as the right ventricular pattern is influenced by the left ventricular pressure changes due to unrestrictive VSD. Normal left ventricular pressure shows mild or no systolic augmentation after a premature ventricular beat because of reflex systemic vasodilatation.<\/p>\n<p>These patients are prone for right heart failure. A prominent &#8216;a&#8217; wave in the jugular venous pulse, not expected in usual TOF, is an important physical finding suggesting suprasystemic right ventricular pressure.<\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"color: #0000ff;\"><strong>References<\/strong><\/span><\/p>\n<ol>\n<li>P R Kumar, A D Rakshak, P Rajagopal, T N Padmanabhan, D S Rao, S Jaishanker. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/9835209\/\">Tetralogy of Fallot With Flap Valve Ventricular Septal Defect Producing Suprasystemic Right Ventricular Pressure: Echocardiographic Observations<\/a>. Indian Heart J. Jul-Aug 1998;50(4):446-50.<\/li>\n<li>\n<div class=\"citation-text\">Soni MR, Bohara DA, Mahajan AU, Nathani PJ. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/22929828\/\">Tetralogy of Fallot with restrictive ventricular septal defect by accessory tricuspid leaflet tissue<\/a>. Indian Heart J. 2012 Jul-Aug;64(4):412-5. doi: 10.1016\/j.ihj.2012.06.009. Epub 2012 Jun 22. PMID: 22929828; PMCID: PMC3860792.<\/div>\n<\/li>\n<li>\n<div class=\"citation-text\">Kannan BR. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/20300256\/\">Tetralogy of fallot<\/a>. Ann Pediatr Cardiol. 2008 Jul;1(2):135-8. doi: 10.4103\/0974-2069.43880. PMID: 20300256; PMCID: PMC2840752.<\/div>\n<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>In Tetralogy of Fallot with flap valve VSD, a flap attached to the VSD will restrict flow across the VSD and can cause supra systemic RV pressure.<\/p>\n","protected":false},"author":1,"featured_media":33826,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[9],"tags":[1503,1504,3782,3874,3945,4172,4211],"class_list":["post-12891","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-general","tag-flap-attached-to-vsd","tag-flap-valve-ventricular-septal-defect","tag-supra-systemic-right-ventricular-pressure","tag-tetralogy-of-fallot","tag-tof","tag-ventricular-septal-defect","tag-vsd"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Tetralogy of Fallot with flap valve VSD - suprasystemic RV pressure<\/title>\n<meta name=\"description\" content=\"In Tetralogy of Fallot with flap valve VSD, a flap attached to the VSD will restrict flow across the VSD and can cause supra systemic RV pressure.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/johnsonfrancis.org\/professional\/tetralogy-of-fallot-with-flap-valve-vsd\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Tetralogy of Fallot with flap valve VSD - suprasystemic RV pressure\" \/>\n<meta property=\"og:description\" content=\"In Tetralogy of Fallot with flap valve VSD, a flap attached to the VSD will restrict flow across the VSD and can cause supra systemic RV pressure.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/johnsonfrancis.org\/professional\/tetralogy-of-fallot-with-flap-valve-vsd\/\" \/>\n<meta property=\"og:site_name\" content=\"All About Cardiovascular System and Disorders\" \/>\n<meta property=\"article:published_time\" content=\"2014-07-28T13:37:47+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2021-10-29T01:20:11+00:00\" \/>\n<meta name=\"author\" content=\"Johnson Francis\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Johnson Francis\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/tetralogy-of-fallot-with-flap-valve-vsd\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/tetralogy-of-fallot-with-flap-valve-vsd\\\/\"},\"author\":{\"name\":\"Johnson Francis\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"headline\":\"Tetralogy of Fallot with flap valve VSD\",\"datePublished\":\"2014-07-28T13:37:47+00:00\",\"dateModified\":\"2021-10-29T01:20:11+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/tetralogy-of-fallot-with-flap-valve-vsd\\\/\"},\"wordCount\":341,\"publisher\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/tetralogy-of-fallot-with-flap-valve-vsd\\\/#primaryimage\"},\"thumbnailUrl\":\"\",\"keywords\":[\"Flap attached to VSD\",\"flap valve ventricular septal defect\",\"supra systemic right ventricular pressure\",\"Tetralogy of Fallot\",\"TOF\",\"ventricular septal defect\",\"VSD\"],\"articleSection\":[\"General Cardiology\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/tetralogy-of-fallot-with-flap-valve-vsd\\\/\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/tetralogy-of-fallot-with-flap-valve-vsd\\\/\",\"name\":\"Tetralogy of Fallot with flap valve VSD - 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