Pediatric Heart Expert Forum
Heart murmur and AVCD
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Questions in this forum are answered by pediatric cardiologists, cardiothoracic surgeons and anesthesiologists from The Children's Hospital of Philadelphia. This forum is for questions and support about pediatric heart problems, symptoms and topics such as heart murmurs, palpitations, fainting, chest pain, congenital heart defects (including management and intervention), fetal cardiology, adult congenital cardiology, arrhythmias and pre-participation athletic screening.

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Heart murmur and AVCD

Hello Doctor,

Our baby is a couple of weeks short of her first birthday.  Our pediatrician heard the first heart murmur on our baby at the age of 11 months.   The ped referred to Ped. Cardiologist and he confirmed AVCD after taking the EKG plus some tests.... The baby has a complete echo test due next week.  I still could not believe she has a heart defect after being born healthy.  She is with polydactyly - 6 digits on hands and toes as well.  She weighs about 17.8 pounds and is not gaining weight for the last couple of months with poor appetite.

I do not have an answer why she is diagnosed after 11 months and not during her first few weeks/months.  Is there a possibility that this condition was developed after she was born ?  

Thank you,
Jayaprakash.
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Heart murmurs in children are common, and they may appear at almost any age.  Murmurs that are due to congenital heart defects generally do present in the first year of life, although sometimes it can be later than that.  If the pressure in the lungs is higher than normal, it can also delay the appreciation of a heart murmur.  An "AVCD" would stand for "atrioventricular canal defect" which is a complex congenital abnormality that includes a hole in the wall between the upper heart chambers (atrial septal defect/ ASD), a hole between the lower heart chambers that can vary in size (ventricular septal defect/ VSD) and a common valve that connects to the two pumping chambers instead of 2 separate valves. The child is born with this abnormality. Generally if the holes are large, or if the valve has alot of leakage, the children develop signs of congestive heart failure within the first few months of life.  If the AVCD has a small VSD component, they may present later, and this may be the case with your child.  It is important for the pediatric cardiologist to assess the size of the holes, the amount of valve leakage and what the pressure is in the lungs, when the echocardiogram is done.  Unfortunately, this form of congenital heart disease does not get better on its own, and in most cases does require surgical correction, the timing of which depends on the pressure in the lungs, the size of the holes and the heart chambers and how well the child is growing.
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Jeffrey R Boris, M.D.Blank
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