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HEART MURMUR WITH 5mm VSD LEFT TO RIGHT ALONG WITH ASD 3mm
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HEART MURMUR WITH 5mm VSD LEFT TO RIGHT ALONG WITH ASD 3mm

My daughter born on 10th august has been diagnosed by ECHO method that she has 5mm VSD from left to right shunt with 20mm gradient along with 3 mm ASD. doctor said to repeat the TEST after 6 weeks;

what is significance of repeating after six weeks? whether preasure shall get settled so that no surgical closure is necessary now? what can i expect now in mynext appointment ? whether it closes automatically? if how much time it takes?
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773637_tn?1327450515
Dear Ramkrishnan,

Your daughter has been born with a ventricular septal defect (VSD) and an atrial septal defect (ASD), both of which are congenital heart defects.  Although I don’t have all the details about her or her studies, and therefore can’t say for sure, it sounds as if the VSD may be small to moderate sized, and the ASD is small.  This is assuming that your daughter was born at term.  The ASD has an excellent chance of closing by itself.  If it doesn’t, it shouldn’t cause any significant problems.  For now, the pressure across the VSD is low, which we can sometimes see early on in babies.  This happens because the pressure on the right side of the heart is high when babies are first born.  Over the first two months, or so, it decreases and normalizes to about 20-25% of that of the systemic pressure.  Therefore, waiting to repeat the echocardiogram (cardiac ultrasound) will demonstrate whether the pressure across the defect is much higher.  This, along with other clinical evaluation, may help with prediction of whether she will require surgery to close the VSD.  If the pressure is high and the defect is smaller, she will likely not require surgery.  However, if the pressure is low and she is having symptoms of getting out of breath or becoming sweaty with feeds, she will need some medications to help with these symptoms and may be more likely to require surgical closure of her defect.
3 Comments
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Avatar_f_tn
first of all congrats on you new bundle of joy  closure can take a little time. it just depends. I can't really answer your questions, as my son had a large VSD, and a PFO and(which I guess they call it a ASD) and a PDA ligation also in the upper part of his heart. they did several echos on him for the first few months of his life, i was told this is to monitor him
I do want to make a suggestion and you really need to talk to your daughters cardiologist about this, there is an illness and I am not trying to scare you, but there is an illness out there called RSV, it is a cold in you and I and healthy children.  however from what I was told by several cardiologist, premature babies and babies born with a heart defect are at risk of getting this disease and having it be more severe then normally would affect a child. there are shots that the babies get once a month called synagisis (not sure if I am spelling it right) but they get it to help LESSEN the affects of RSV. insurance companies do usually cover them the shots are once a month for the winter season and they get it for the first 2 years of their lives. my son got RSV when he was 5 weeks old, he didn't get his first shot yet and he was really really ill. then when he was almost 2 he got it again, thankfully he got the shot he might have been really sick again. please consider asking your daughter's cardiologist if she would require it or not. my son was not a premature baby.
Good luck and I wish you guys the best
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Avatar_m_tn
I am not a doctor.
The pressures on the right side of the heart drop after about 2 months as part of the natural transition from when a baby goes from the womb to the outside world.  The gradient across the VSD may rise, so do not be surprised on the next visit with the heart doctor.  Sometimes the ASDs and the VSDs can go away on their own, so as long as your baby can tolerate having these holes, the heart doctor will most likely take a wait and see approach.  The doctor may not be able to accurately predict if the holes will close on their own or not.  He cannot see into the future.  I am not sure about the ASDs, though in my experience, if they are going to close, it will be within a year.  The VSD can also close but the time frame for that is longer, in the two year range.  Without seeing the echo images, it is hard to say.  Basically you will have to wait and see if the ASd and VSD close as your baby gets older.  
  How they will determine surgery vs. device placement vs. waiting is something you pediatric heart doctor can give you in time and it it also is highly dependent on whther or not the holes close vs. just one hole closing.

Good luck.
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The Children’s Hospital of Philadelphia
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