Posted By CCF CARDIO MD - MTR on October 23, 1998 at 10:06:44:
In Reply to: Enlarged heart in infant posted by Laurel on October 22, 1998 at 17:30:31:
On Oct. 1st, after my infant son refused to drink his bottle after a few *****,
and was blue around the mouth and gagged to the point of choking while eating 5 times in 3 days, we took him to our pediatrician. We thought he might have GastroEsophagal Reflux, but our pediatrician was more concerned about a possible cardiac problem. Our baby was 2 months old then. We had a blood oxygenation level taken (fine...98-100%), an EKG done (we were told that was also fine), his heartrate was 118 beats per minute, and we were told at that time that his chest x-ray was good, lungs clear, heart fine. After the heart was no longer a concern, the hospitial pediatrician thought Reflux might indeed be his problem, and that the blue around the mouth could be there from aspirating.
Since that time he has been diagnosed with GER...and is being treated for it with some decent results. The night we came home from the hospital from having the cardiac tests, we started treating Ian for reflux and changed our care habits for him, including elevating the head of his crib, holding him upright as much as possible, etc. After having blue around the mouth for 3 days, before we made these changes, after having made them, the blue completely disappeared and has not returned. We changed pediatricians because the one who sent us for the cardiac tests refused to acknowledge our son's GER for which he needed treatment. He is now with a good pediatrician at a different hospital.
Then this weekend, nearly 3 wks. after the hospital staff in the E.R. told us his heart looked fine in the x-ray we have been given a hospital report saying,
"Findings-The lungs are clear. The cardiac size is mildly enlarged. The pulmonary vasculature is unremarkable." and also, "Impression-Mildly enlarged cardiac silhouette. Recommend additional imaging to further evaluate this patient."
Our new pediatrician is on vacation for a few more days. I've faxed this report to her partners, but being new to this practice, and since this is not an emergency we are waiting for her return to have this double-checked.
My question is, what does an enlarged heart represent? Is it a symptom or is it a condition in and of itself? What can you tell me about enlarged hearts in infants and/or where can I read up about it? My son will be 12 wks. old the day after tomorrow, and seems perfectly fine, save a few lingering reflux symptoms.
Dear Laurel, thank you for your question. It sounds like your son has had a thorough cardiac work-up which has excluded cardiac abnormalities. The finding on the chest x-ray is subjective and does not indicate that he has a cardiac abnormality. When a chest x-ray is done, the heart size is determined by the radiologist who is interpreting the chest x-ray. Depending on the angle of the x-ray beam that is used to take the chest x-ray, the heart size can appear larger or smaller than it really is. These findings are artifacts of how the radiologic study is performed. Thus, since all the other cardiac tests have been normal, I doubt this chest x-ray result truly indicates your son has an enlarged heart. You shouldn't worry about this chest x-ray result and I think it would be fine to wait until your pediatrician returns to discuss the results. After you have this discussion, your pediatrician can refer you to sources of more information if necessary.
I hope you find this information useful. Information provided in the heart forum is for general purposes only. Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.
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