Hypercyanotic/ Tet Spell Treatment? (Fallot)

[PremedSurvivor]

In terms of pathophys, I was under the impression that increased venous return is considered "bad" because it increases RV pressure and worsens the right to left shunting into the aorta. If that's the case, why does treatment of a hypercyanotic spell involve giving an IV fluid bolus? Isn't that the same thing mechanistically?

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[KVBane]

Increased venous return will increase the pressure on the right side of the heart, and this will prevent shunting of blood through the VSD from left to right.

I think...

 

[chromuffin]

Increased right ventricular pressure will also decrease the afterload(right term?) from the pulmonary stenosis. Think of it as compensation for the forces from the VSD and stenosis.