Pediatric Heart Expert Forum
New Measurement (ADMIN, pls delete post "can I stop worrying"...
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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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New Measurement (ADMIN, pls delete post "can I stop worrying")

I posted last year about my sons dilated ascending aorta (it was 2.6cm at the time), as well as root and annulus.  He just had his yearly check up (turned 4 this month) and it is now dilated to 2.86 and our cardio said Boston will probably want an MRI.  His z-score last year was 5.34 ish, I don't know what it is this year b/c I haven't gotten the report yet but I'm guessing it's higher now.  

My question is how likely is the MRI measurement to be different than the echo measurment?, and at what point do we have to begin talking about activity restrictions if at all?  We won't see our cardio for about six months and am wondering about the future, which I know none of us can predict.  Our son is VERY active and we wanted to start him rock climbing at center this winter as well as baseball and other sports next year, he also rough houses around quite a bit.  If his aorta continues to dilate, when are we looking at the beginning of activity resctrictions? (thankfully on none right now).  

Thank you so much.

The absolute measurements of the blood vessels in children will always increase over time, as their body grows.  As you know, the z-score is what is tracked.  However, if it has gone from 2.6 cm to 2.86 cm in 1 year, assuming that his bodily growth is normal, that is not much of a significant change (2-3 mm), so the z-score will likely be similar.  This is far from needing an intervention.  Activity restrictions for dilated aortas would include significant contact sports (those with high risk of bodily collison or being struck by a stick) and high isometrics (like weight lifting and football) at a competitve level.  You should really NOT be thinking about enrolling him in such activities over the long term at a team level.   We do like baseball very much in the pediatric cardiology community.  You will need to speak directly with your pediatric cardiologist regarding their personal recommendations on sports participation, because there is not alot of information out there to clearly state what an arterial switch patient should or should not do.
Thank you for your advice as always : ).  His cardiologist says he can be treated as normal which is great because he is a very active little boy but we will keep in mind your advice for which direction we try to steer him in (as much as he'll allow us)  

His knew z-scores came back as follows:

Ao Annulus Z of 3.01
Ao Root      Z of 3.17
STJ            Z of  5.1
Ascending  Z of  5.58
Ao Ithsmus Z of -0.57

He has a re-check in in 6 month with no MRI at this time.  There is another number I am not familiar with if you could help?  The M-Mode LV Mass/Height is 57.49 g/m and the M-Mode LV Mass/Height^2.7 is 47.42 gm. What is this in reference too and what's the difference between the two, it's the only other one in black on the report. Thank you once again.  
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