Pediatric Heart Expert Forum
Small vsd and enlarged left heart
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Small vsd and enlarged left heart

I posted here a while ago and received a very helpful answer and I wonder if someone could provide me with some more reassurance.

My daughter was diagnosed with a small muscular VSD at 12 weeks. The report letter we received stated it was 3.5mm and there was some mild left heart enlargement.

She is now 6 months and had her second echo yesterday. The consultant told us the hole is tiny and he even struggled to measure it, the maximum measurement he got was 2mm. Presumably then going by the previous report the hole is closing although the consultant didn't pick up on this so I'm not sure if the previous measurement on the report was correct. The thing that is concerning me is that the left side of her heart is still mildly enlarged although it hasn't got any worse. Does this sound normal for such a small hole? Everything I read says that a hole of that size shouldn't cause any problems so I'm worried she is not coping with it as well as she should. She isn't showing any symptoms and is putting on weight well. The consultant was happy with her progress aside from the enlargement and doesn't want to see her again for a year. This seems like such a long time! I'm sure I come across as a paranoid mum but she's my baby girl and I'm struggling to come to terms with the fact there is something wrong. I also would like to understand what the long term consequences could be if this enlargement continues as the consultant wouldn't speculate.

Thank you in advance.
773637_tn?1327450515
Dear Ammdaz,

Since I am not able to evaluate your daughter, I cannot say exactly how bad things actually are.  I can say that a 2 mm VSD is truly hemodynamically insignificant, which actually means that it's too small to cause any chamber enlargement.  The concern for the chamber enlargement would be more of an issue in several ways.  First, if the heart's function is not normal, then that would be a problem; normal function with a bit of enlargement is likely not a big concern.  Second, if the chamber size was greatly enlarged, that would also be a problem; sometimes the chamber can be measured at "the upper limits of normal", which is still normal but a bit larger.  Third, if there was a family history of a cardiomyopathy, which is a genetic abnormality of the heart muscle, that would also be a greater concern.  Since she is only 6 months old (and assuming that she is othewise healthy, growing well, and doing well), this can most likely be observed.  In the end, the echocardiogram is just a test, and test results have to be placed in context of the actual patient.  I would discuss this further with your cardiologist.  If you feel that you are not getting the answers/information that you want, you can always consider a second opinion.
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Thank you for your reply. Yes that is what I thought, that such a small vsd shouldn't really be causing any enlargement. The cardiologist did say her heart function is normal and the enlargement was only mild. He didn't give any explanation for the enlargement other than the VSD and as far as I know her heart is otherwise normal. We have no family history of cardiomyopathy as far as I'm aware. She is otherwise well and putting on weight. I suppose I'm just confused as to why she's showing this symptom and worried that something else may be causing it. I am going to discuss with her cardiologist but he's not easy to get hold of and it will be at least next week before I can speak to him. Thank you again for taking the time to reply.
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Avatar_f_tn
Thank you for your reply. Yes that is what I thought, that such a small vsd shouldn't really be causing any enlargement. The cardiologist did say her heart function is normal and the enlargement was only mild. He didn't give any explanation for the enlargement other than the VSD and as far as I know her heart is otherwise normal. We have no family history of cardiomyopathy as far as I'm aware. She is otherwise well and putting on weight. I suppose I'm just confused as to why she's showing this symptom and worried that something else may be causing it. I am going to discuss with her cardiologist but he's not easy to get hold of and it will be at least next week before I can speak to him. Thank you again for taking the time to reply.
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