size of asd gradually increasing with pulmonary hypertension

[saifulislam]

I am father of a son born in 36 weeks.on 3rd day the echo shows 3.3 mm pda and 3.3 mm asd.on next echo at 10 th day pda closed and asd remains in 1.8 mm.on next follow up echo at 1 month 10 days asd again increased to 3 mm. and very unfortunately the last echo on 2 month 20 days show large asd 5.7 mm.right atrium,ventricle and pulmonary artery mildly dilated,mild pulmonary hypertension.Now my question is can size of asd increase so rapidly once it was diminished?why pulmonary hypertension develops in 2 month age?is there any hope that the condition may improve?he born with 2.54 kg and on 3 month 10 days he is 5 kg.waiting eagerly for reply

[Skatenurse]

If you have a hole in the divider (septum) between the chambers of your heart changes in volume and or pressure in any of the chambers or the lungs size of the opening May increase. Infants can be born with pulmonary hypertension. My youngest who is now 18 years old was born with pulmonary hypertension secondary two my own high blood pressure which was a result of my having toxemia while I was pregnant. We knew from the clinical picture my son would be born some level of premature. My OBGYN decided I should get steroid injections two Force the baby's lungs to mature more quickly in anticipation of the premature birth. The steroids work by basically irritating the lungs forcing them to produce more of the chemicals that keep the air sacs inflated. The level of these chemicals are almost assuredly lower than optimal with prematurity and the amount is lesser and lesser the more premature a baby is generally speaking. When she gave me these injections she was not thinking that because I had toxemia for such a while that my own high blood pressure was stressing his lungs this steroids put him over the fence and into pulmonary hypertension territory. He was born and immediately put on a ventilator. The NICU doctor told me he that two out of three babies born with this do not survive the first 24 hours of life. Pulmonary hypertension simply means high blood pressure in the blood vessels of the lungs. It is usually caused by pressure changes somewhere in the circulatory system not necessarily a direct problem with the lungs. Like in my case my son had pulmonary hypertension secondary to maternal toxemia. I myself was born with a large ASD/ VSD, approximately two-thirds of my septum was missing. In addition, I had mitral stenosis my mitral valve was nearly fused shut. The ASD vsd was a lifesaver at that time as it allowed my lungs and body to get blood and enabled me to breathe. I was almost 10 years old when my original repair was done and they opened up my own mitral valve and put a Dacron patch over the large hole in my septum. 30 years later 5 months before it would have been exactly 30 years I went back to the O.R. and my natural mitral valve which was by this time shot, was replaced with a mechanical one and I just had the 18th anniversary on the same valve praise God. The patch on my septum however is still the original one which is now 47 years old. However we have known for about 7 years that I have an aneurysm or bubble outpouching from that patch. So now with my yearly Echo we check to see whether the patch is still intact once it develops a hole in that bubble I will need surgery again