Pediatric Heart Expert Forum
Small mid muscular VSD shunting left to right 1.6 mm size
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Small mid muscular VSD shunting left to right 1.6 mm size

Hello Doctor,
Soon after the birth of my twin daughters, they were taken for cardiacevaluation. One of them was diagonised with a small mid muscular VSD shunting left to right, measuring 1.6mm in size. The doctor said that she needed no medical intervention, and was told to come back after 6 months, as there was a high chance of the hole closing by itself. Itook her back, still there were no changes. Now i have been told to bring her back after 6 months. presently she is 7 months old. Her last TRANSTHORACIC ECHOCARDIOGRAM showed the the following segmental and sequential analysis.
Situs solitus, levocardia
normal venous connections
normal AV and VA concordance
intact IA septum
dominant left atrium and ventricle, no evidence of ventricle hypertrophy, good systolic and diastolic function
normal and competent all other cardic valves
normal pulmonary vasculature
normal origin of coronaries
no PDA seen
normal left aortic arch
no pericardial effusion

Am very much worried about her. Can u please let me know the precautions i should take for her and is there any possibility that this hole can be closed with just medication and are there any long term side effects of this disease.
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A 1.6 mm mid-muscular VSD is extremely small and has a high chance of spontaneous closure.  Even if it never closes, it should cause no cardiac symptoms.  There are no precautions to be taken.  There are no medications to treat this, not are antibiotics needed for procedures or dental work (per USA recommendations).  Although I am sure that you are concerned, this is not a serious type of congenital heart condition. Your daughter would be expected to perform like a normal child.
2 Comments
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What that means is that basically your daughter is fine!!!
While I'm not a doctor, my daughter was born with a large VSD and ASD.
A 1.6mm VSD is small, has a great chance of closure and even if it doesn't, is likely small enough to never cause an issue.
Her echo report basically states that everything is fine:
situs solitus, levocardia means that her heart and organ positions are normal.
Her veins and valves are fine. She has good heart function, the left side of her heart is dominant (normal) and she has no evidence of enlargement (hypertrophy).
Her pulmonary arteries etc... are fine, she has no PDA (another heart defect), all is well.
She's not having any signs of heart failure, so she wouldn't need any medication, and since her hole is so small, it likely is never going to cause her any issues.
Talk to her doctor about the possibility of needing antibiotics prior to dental work to prevent the (slim) chance of endocarditis. Again, I'm NOT a doctor, just a mom who's had a lot of experience with this,.
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Jeffrey R Boris, M.D.Blank
The Children’s Hospital of Philadelphia
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