Pediatric Heart Expert Forum
VSD 2 years old child
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VSD 2 years old child

Dear Doctor,
My child is 27 months old with moderate size vsd (5 or 6 mm) with tissue from valve parly closing to make it smaller. She have no symptoms and has been seen periodically by pediatric cardiologist. She never take medication for this due to tissue help close it and they do not know if ever will close totally and will keep a watch on it over these next years. She will now not go back for checking for a whole year, I worry what could happen. She used to have enlargement but now they said it is almost back to normal sized. But her ekg show "prominent ventricular forces" but otherwise normal. Does this mean heart will be working too hard or enlarging again? He say all pressures and valves in heart are normal too and yes her heart work a little inefficiently compare to other kids with no vsd but that is ok too. Do I worry about ekg prominent ventricular forces even though all heart otherwise look well (beside the vsd of course)?
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773637_tn?1327450515
Dear Marcella,

Without evaluating your daughter, I cannot say for sure what is or will happen with her ventricular septal defect.  However, if she is growing well and has no symptoms, and there is no chamber enlargement on echocardiography, it sounds like she is doing well.  It is not as important for the defect to close as it is for it to just be small, or restrictive, in size so that less blood goes across it.  The EKG findings are not nearly as important, as they can take a while to resolve.

I do not know where the VSD is, but by your description I am guessing that it is a perimembranous defect.  This means that it is up by the aortic valve.  I am hoping that the tissue that is closing it is from the tricuspid valve, and not from the aortic valve.  If this is so, then she should do well.  If it is from the aortic valve, this will need to be watched closely for aortic valve prolapse and leakage.
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Doctor thank you so much for responses. I appreciate it very much. You are correct this what they told us is paramembranous vsd (sub aortic it say) and that is tricupid valve tissue covering they say. And they say aortic valve look perfect right now but they say chance of it damaging is very small but to keep watch on it as long as there is hole. But some doctor say this hole will probably not close and some doctor say yes it can. But maybe that size is too large to close up on its own?
But yes thank you, I was worrying about ekg finding prominent ventricular forces, sounded not good. Thanks doctor.
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773637_tn?1327450515
Jeffrey R Boris, M.D.Blank
The Children’s Hospital of Philadelphia
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