10 month old, Enlarged Heart, Heart Murmur, always sick

[adroser]

I have been searching the net looking for answers and am afraid that I am only finding things to scare me more.  My son had a consistant fever for two days, after having a cold for about a week, so we took him into the pediatrician.  She ordered a chest xray just to rule out phneumonia, but called us quickly after the xray to let us know that she was concerned that his heart was quite enlarged on the xray, and that it was showing too much blood flow or fluid build up in the lungs due to him having an enlarged heart.  (I believe that's what she said, but was caught off guard and didn't really understand what she meant at the time).  She also mentioned that she had heard a slight heart murmur when listening to his chest earlier that day.  She told me that she had contacted the a pediatric cardiologist to see if he thought he should be seen right away, but that he thought it could wait until Tuesday (this all took place on Saturday).  We are supposed to go in to see him on Tuesday.  My son's flu is much better, although he's still congested in his chest.  He does not have a fever anymore.  Some other things about my son which may or may not be relevant.... He has a peanut and egg allergy.  He had severe ezcema until 8 mos when I learned of the peanut allergy and cut ALL peanut out of MY diet (he was bfing).  His pediatrician has suspected that he might have asthma because of how badly/quickly he gets sick with each "cold".  He sweats SO much on his head when he nurses.  Sorry this is sooo long, but my questions are:  Is it possible this is nothing to worry about and his heart may just be enlarged because he was fighting a cold/flu?  Is it true that the majority of the time an infant has an enlarged heart, because they have cardiomyopothy?  Any other insight you may have would also be wonderful!  Thank you for taking the time to look at this and help us!  It's so hard to worry about your baby, yet know there's not really anything you can do to make it all better!

[Jeffrey R Boris, M.D.]

Dear Adroser,
It is difficult to say exactly what is going on here.  Sometimes, a chest x-ray can demonstrate an enlarged heart due to poor radiographic technique; if the film doesn’t show a deep enough inspiration, the heart can look enlarged and it can make it look as if there is extra fluid in the lungs.  However, if this is not the case and there is actually evidence of an enlarged heart, the most likely cause for this could be what is called myocarditis.  This is an infection of the heart in which the heart muscle is infected, typically by a virus.  Between the viral infection and the immune response to the virus, the two processes can damage the heart and lead to decreased heart function with congestive heart failure, inability of the heart to meet the body’s needs.  The heart does not enlarge just due to “fighting an infection.”  A cardiomyopathy is a general term that is used to describe diseased heart in some way.  Myocarditis can lead to a dilated cardiomyopathy, although there can be other reasons for dilated cardiomyopathy, such as genetic or anatomic.  I agree that a pediatric cardiology evaluation would be helpful in this case, and should determine if there is actual disease in your son’s heart, or not.

[adroser]

I also forgot to mention two other symptons.  This evening we noticed he had very obvious looking purple reddish circles under his eyes.  We've never noticed this on him before and thought it very strange.

When he was sick with his fever, he had very rapid breathing when sleeping.  

The pediatrician also mentioned that he was breathing from his belly instead of his chest and it would invert below his sternum.