Pediatric Heart Expert Forum
heart murmur in a 10 year old
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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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heart murmur in a 10 year old

My daughter was diagnosed with a hole in her heart at birth.  At 18 months of age, the cardiologist released her...the murmur was no longer audible "the hole had closed".   No doctor, and she has seen many, including her pediatrician... has heard her a murmur for 8 years.  She is  10 years old.  3 months ago she was ill and I took her to the doctor and they suddenly heard the murmur which is quite audible...thus a echocardiogram which showed a the hole under her aortic valve.  Have you ever heard of a  case?  The cardiologist feels that the aortic valve may have prolapsed into the hole..maybe needing open heart.  why is it audible again after 8 years?
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Dear Tory,

Although I cannot say for sure, it sounds as if your daughter may have had a ventricular septal defect (VSD).  As well, it sounds as if this VSD was in the perimembranous or conoventricular region, which is just below the aortic valve.  These defects can spontaneously close over time.  Usually, they close with extra tissue from one of the leaflets of the tricuspid valve, the first valve on the right side of the heart.  However, occasionally they can close due to prolapse of one of the cusps of the aortic valve, the second valve on the left side.  If this happens, the aortic valve can leak over time.  I do not know what the source of the murmur is in your daughter in this case, as there is more than one potential reason for it.  However, if the murmur is due to a leak in the aortic valve after the aortic valve was distorted by trying to cover the VSD, unfortunately it will require surgical repair.  I am not aware of specific cases in which the murmur disappeared and then reappeared, but have definitely heard of cases occurring the way I am describing it.  If you feel that you are not getting the answers that you need from your cardiologist, you may consider obtaining a second opinion.
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Jeffrey R Boris, M.D.Blank
The Children’s Hospital of Philadelphia
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