Our daughter has a moderate VSD, small ASD, is in moderate congestive heart failure. She was admitted to the hospital on Monday with failure to thrive. While there they checked her blood pressure which was 109/72, and the nurse said she thought that was a bit high. We didn't see the cardiologist.
Is that reading high for her age (9.5 weeks)? Or would that be considered normal for a baby with her condition? She's currently on 4 mg Lasix, 2 mg Spironolactone and 20 mcg Digoxin, twice daily.
A blood pressure of 109/72 is, in fact, elevated for an infant, no matter what their condition. For infants less than 12 months, we like to see a systolic blood pressure (upper number) less than 100. However, there are several factors that can falsely influence the blood pressure number. First is that blood pressures are often measured by machines, instead of manually; these machines often tend to overestimate the blood pressure. Second, if she was wiggling or moving, that could falsely elevate the reading. Third, sometimes the measurement is taken in the leg if an arm measurement can’t be obtained; these are typically higher, as well. Therefore, do make sure that a blood pressure is measured with an appropriate sized cuff in the right arm using a manual blood pressure device (called a sphygmomanometer). Finally, if this number remains high, it would be important to make sure that she does not have coarctation of the aorta, which is an obstruction of the aorta that can elevate the blood pressure abnormally.
Hang in there. She sounds like a trooper and so are you. I know what you are gong through.was there 6 1/2 years ago. you get to see her cardiologist next month, I bet you can't wait. It has to be hard that she has never seen the cardiologist. Hopefully when they see her the surgery will be soon after. now that she has the NG tube in is she gaining? Hugs to you and your family.
At the time the blood pressure was taken she was alert, but not overly active and was not crying. It was taken with an automatic machine. She has had 2 more readings done since then, all laying down, calm (but awake) with an automatic machine. The readings have been 120/67 & 95/68. Her bottom # is consistently high. Is this something that may need to be treated with medications?
The bottom numbers (diastolic blood pressure) are not actually measured by a machine, but are calculated. Therefore, to get an accurate measurement, a manual blood pressure with an appropriate sized cuff needs to be performed. I would not consider any therapy for this until an accurate measurement is obtained.
She had her pressure checked manually today, with an infant cuff. She was awake but settled, and her numbers were still high. Her L arm readings were: 128/62 & 130/68 and her R arm was 126/52.
So given that she's had 7 high readings, consistently with bottom #'s in the 60's and upper numbers over 100, VSD, ASD, CHF (taking Lasix, Spironolactone & Digoxin), is there a course of action that should be taken?
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