Pediatric Heart Expert Forum
PDA,ASD,VSD
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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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PDA,ASD,VSD

Dear Sir,
My baby(female) is 5 days old and her echo report is as follows:
Congenital heart disease:Perimembranous VSD extension to subaortic and inlet area(5.3mm),PDA(4.0mm),Both predominently left to right shunt,ASD Secundum( 3.4mm),Left to right shunt,IAS aneurysm present.Moderate to severe TR with Moderate PAII,(estimated PASP = 49+10=59mmHg) Dilated RA and RV (Poor echo window)
Please suggest me regarding medicine,surgery and when can it be done.
Arjun,Nepal
773637_tn?1327450515
Dear Arjun,

Based on your description, it is not completely clear that anything needs to be done at this point.  The atrial septal defect is relatively small, and may close by itself.  The VSD is moderate sized and may be able to shrink enough to become restrictive to blood flow so that it is effectively small.  If this is the case, surgery is not required.  The ductus arteriosus (PDA) typically closes by age one year.  

Obviously without evaluating your daughter, I can't say exactly what needs to be done.  I will say that you will need to observe her for getting out of breath with feeds or getting sweaty with feeds, as this will indicate that her heart is working harder than normal and that she may need some medications to reduce that work.  If she fails medications, she will need surgery.  These symptoms typically start in the first 1 to 2 months after birth, so it's pretty early to be concerned at this point.  However, she should have routine follow-up with her pediatric cardiologist to ensure that she is doing well.
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