Pediatric Heart Expert Forum
VSD <4mm
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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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VSD &lt;4mm

Dear Sir,
My baby girl was found to have a mid muscular VSD (5-7mm size) and a small ASD. It was detected on the third day of her birth.Her birth weight was 3.17Kg. As symptoms of heart failure has started, our Pediatric Cardiologist started medicines. During an echo test at the 4th month it was found that the ASD was closed and the size of the VSD has been reduced (lessthan 4mm). Now she is 4 1/2 months and 5Kg. She is gaining weight very slowly.Feeding is poor. Also there is a breathing problem for her.What are the things we should do to increase her weight? Is surgery needed for this defect?    
Tags: VSD
773655_tn?1340656399
It sounds like the ventricular septal defect (VSD) was moderate to large (5-7 mm) at birth and that would account for the heart failure symptoms you describe: poor feeding, breathing problems and poor weight gain.  Although the VSD size may be measuring smaller, there can still be a large amount of blood flow through the hole, and that can cause symptoms to persist.  What is important to find out from your child's cardiologist is whether the VSD is now "restrictive", which means in addition to being smaller, there is also a restriction of pressure transmission between the 2 pumping chambers.  If this is the case, then the VSD can be watched a while longer and see if there is more spontaneous closure.  If the VSD flow is "non-restrictive" then the pressure in the lungs is high and the VSD may need surgical intervention soon. You should also talk to your cardiologist about increasing the dose of your child's diuretic medication, as that may help some symptoms. If your child cannot eat well by mouth, then insertion of a feeding tube may be necessary to get the proper amount of calories in, and help growth.  If that doesn't work or cannot be done, then surgery may need to be considered.
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