Enlarged Heart with Tachycardia and Fainting Spells

[bethurrabazo]

Hi...my daughter had ASD repair (no wall separating the two upper chambers) when she was 11 months old. She went for her follow-up at 5 years old and they noted that the left side of her heart was still considerably enlarged and has tachycardia. They stated this was normal. She is now 11 years old and is experiencing fainting spells and her tachycardia is very noticeable to her. She also has moderate learning disabilities and is a full time Special Education student.

My questions are:

Do the fainting spells and tachycardia have anything to do with her enlarged heart and if so, should we seek medical attention? I was never given any information on what to expect and after her 5th year evaluation, I was told that she wouldn't need anymore follow-ups. That didn't set well with me, but hey, they're the docs and they know what they're talking about, right?

Can her heart condition be the cause of her learning disabilities (i.e. due to the lack of oxygen, etc.)?

Thank you so much for your time and help.

[grendslori]

You bring up a lot of good points and I am going to try and answer your questions.

1) You SHOULD be seeking the advice of a Pediatric Cardiologist with your daughter. If her left ventricle is enlarged you need to keep an eye on that and to understand why it has become enlarged. Are the chambers enlarged with thinned out walls or are the walls thickened with the chambers too small? The former is Dilated Cardiomyopathy (DCM) and the latter is Hypertrophic Cardiomyopathy (HCM or HOCM) Both can cause arrhythmia problems and cause a person to pass out. What do you mean that her tachycardia is very noticeable in her? It wouldn't hurt for her to have a 30 day Event Monitor (sometimes called a King of Heart's Monitor) Having said all of that, there are many reasons for a child/teen to pass out; dehydration and lack of eating are two prime reasons. Hydration includes not only drinking plenty of fluid but along with that eating plenty of protein as it is the protein that helps to keep the fluid in the body. Drinking will not accomplish that for many people, on it's own. Obviously the youngster who takes off for school without eating a good breakfast, or eating a breakfast high in sugar, can have serious drops in blood glucose levels and that is a cause of them to also pass out. One other thing is orthostats where there is a problem with blood pressures dropping when a person stands up too quickly and passes out. The Tilt Table Test can be used to diagnose that type of problem.

2) your second question dealt with a learning disability question which I found very interesting because I have had to deal with something VERY similiar. My daughter had a severe form of HCM which affected both ventricles. We were living in England at the time and she was attending a British Primary school (those kids are SO FAR advanced on these kids here in the US) At four, she had a photographic memory, literally., At six (when she was diagnosed with HCM) she was given a math test of addition, subtraction, multiplication, division and basic algebra. Out of the 150 problems on her test; she made three mistakes. Two of the mistakes we were told had the 'signs' been right, the answers would have been right, in other words, she added when she saw a multiplication X and she subtracted when she saw a division sign with the --- with the two upper and lower dots; the answers she gave had the signs been read correctly would have been the right answer. The third mistake, no one could figure out where she came up with the answer from. She had an IQ one point off from genius. The British schools advanced her and by then she was in the 3rd grade. My husband would stand in line with my two daughters at the store and to pass the time would rattle off groups of numbers for the girls to add or subtract for something to do while waiting and she would have the answers blurted out before her sister had a chance to answer.  We returned to the States two years later and she went through an open heart surgery to correct W-P-W. A year or so later she was failing math. She was still a good student overall, but nowhere near the student she had been. Her IQ level dropped by over 20 points. Not too horribly long ago there was a program I saw on PBS ( I believe) where there was  discussion about the use of the heart lung machine and the loss of brain abilities. The theory was that when the blood passes through the tubing, it picks up anything that is there and transports it to the brain which kicks in the immune system which can damage the brain cells. If this is true...heaven knows, but it made sense. The loss of brain function in my daughter has been discussed with her doctors on many occasions and I was told that because of the severity of her heart function (HCM) the loss of her abilities was a result. She too was in Special Ed because she could not participate in Physical Ed and was listed as "Other Health Imapired" She did not attend Special Ed for one hour a day (in place of Phys Ed) because of a learning disability. Funny thing, after she received her heart transplant, her IQ went right back up to the genius level; she said her math skills were coming back and her thinking was returning!! That would certainly justify all of our belief that the bad heart was a cause for the problems she had. So could a lack of oxygen be a cause of your daughter's learning disabilities? Perhaps yes, however, it would have to be a severe enough form of heart disease to cause it and having said that, ask her doctor that question, he should be able to give you an answer. Take care!

[bethurrabazo]

Thank you so much. Your information has been extremely helpful. To add to the heart lung machine you mentioned, they were not able to start my daughter's heart back up right away. They had to "shock" her heart 5 times and the fifth time was going to be their last attempt. Praise God for her willingness to fight!!

I will definitely get her in to see her cardiologist as the fainting spells are very alarming. She eats a very good breakfast, but she tends to faint after overexerting herself. The tachycardia being noticeable to her is when she tells me she feels like her heart is beating so fast, she thinks it's going to burst. When I check her pulse, she's right. And that's not even when she's active. She's just sitting on the couch watching Hannah Montana.

Thanks again for your advice. If you don't mind, I would like to keep you posted on her outcome. Take care and God bless!!

[grendslori]

Please do keep me posted on how she is doing, I would love to know. One thing you must keep track of if possible is to try and pay attention to whether or not her fast heart rates start and stop on a dime or whether or not the rates increase with time and decrease with time. Rates that start and stop on a dime are true arrhythmias and it's important for her doctor to know that. Also try and see if you can get an Event Monitor on her so that you have the results to discuss with her doctor at the appointment. make sure and tell him about her passing out after exercising, that can also be very important for him to know; he may want to order a Stress Test. take care!