Pediatric Heart Expert Forum
Question about Interstitial Markings on xray
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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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Question about Interstitial Markings on xray

Back when our daughter was in heart failure her tests showed: slightly prominent central pulmonary vasculature with increased interstitial marking bilaterally. She had another xray a few months later that showed something similar, scarring or markings in the lungs.

She's doing great now, and her cardiac issues have resolved, however what my wondering is: what was this that was seen, is it something that's completely resolved, or is this damage to her lungs that she'll always have?
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Dear MSHanson,

As I recall, your daughter had a nonrestrictive ventricular septal defect (VSD).  When this happens, extra blood recirculates from the left side of the heart to the right side of the heart and returns to the lungs.  This extra volume causes enlargement of the pulmonary artery.  As well, the extra amount of blood pushes out through the thin walled capillaries of the lungs and out into the "interstitum," or the spaces between the alveoli (air sacs) and the blood vessels.  However, once the VSD is closed or becomes restrictive to flow, that extra volume disappears.  The pulmonary artery returns to normal size and the fluid in the interstitium gets reabsorbed back into the blood stream.  It is not a permanent change.
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Wonderful, thank you. We're currently trying to get health insurance for her, and this was a question that had come up.
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