My 4 year old daughter has a VSD. It was diagnosed when she was born. After all the routine tests, they advised us that it was very small and wouldn't cause any problems. For her first year of life we had follow ups with her cardiologist. At her last appointment with her doctor, she was crying the whole time, and he didn't get a good listen to her heart. He advised us it had closed. Just by chance a couple years later, I was at a cardiologist appointment, and she was with me. I advised the doctor that she had a VSD but it had closed. He took a listen, and said it hadn't closed, he could hear it. So I took her to a different pediatric cardiologist, feeling like the first one had discharged us without making sure she was ok. He listenend and said she either still had the VSD, or and innocent murmur. We followed up again with him, and he said it was definately her VSD. He said it should close by the time she is 10. My question is, she is very small, my most petite child, and I have asked her doctor if it is related to her VSD, he said if she is showing no other symptoms, than probably not. I have heard many horror stories about small VSD's causing problems later in life. Is this true? For now we are just following up annually with her doctor, and were advised to take meds if has any surgery's, dental work, etc. She does sweat in her sleep, and tires easily. I guess I just want to be reassured that a small VSD isn't anything to worry about, that is how the doctors make it seem. Her pediatrician says as long as she doesn't plateau we're ok. Thank you.
The natural course of alot of VSDs detected in childhood are thought to be self limited as you mentioned. However, it really seems as if there is significant debate over what your physicians are telling you after listening to your childs heart. An experienced physician, however, can usually tell quite a bit about the abnormality simply through listening to the heart.
Perhaps a visit specifically to a pediatric cardiologist could clarify issues for you and confirm the diagnosis. Other tests that can help confirm the diagnosis or impact of the VSD beyond the physical examination in complex cases are ECGs and echocardiography.
Thank you for your response. Her cardiologist is a pediatric cardiologist. And did state at her last appointment it was a VSD. When she was a newborn she had an ultrasound to confirm it was a small VSD. I guess my question is, does a small VSD cause problems later in life, if they don't close? And are there any specific things to watch out for? Thank you.
The thing to remember is VSDs do not get larger as the body grows. Often they can get smaller and completely close. This is why a less invasive approach is taken often. The main risk is the risk of infection espesially with dental procedures. This is why antibiotics are recommended as prophylaxis.
If your child is growing normally and meeting milestones, I would continue a less invasive approach with periodic (ie yearly-every other year) checkups with a pediatric cardiologist.
If things get confusing he/she would probably reimage with an ultrasound.
In the coming years, small VSDs will probably be routinely closed without surgery taking a percutaneous approach.
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