Pediatric Heart Expert Forum
my sons heart condition
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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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my sons heart condition

my son was born a blue baby and one side of his heart was inflated.since he was born in a hospital with less fecilities, it took them 15 days to diagose him.he later got diaganosed with pulmonary atresia and a balloon surgery was performed on him.he started breathing on his own after the surgery.and was discharged when he was 26 days.
he leter became a normal boy and his weight is normal too and have covered his milestones so far.but the thing is he is one and recently in one of his xrays the docter said he had a comparatively bigger heart than normal babies and it could be due to his pre operation condition.how long will it take for the heart to get to the normal size and does having a big heart have any problems .his saturation levels are 98 to 100...usually
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773637_tn?1327450515
Dear SA,

Without fully evaluating your child’s studies, or your child, I cannot tell you why the heart is larger.  Pulmonary atresia is a congenital cardiac defect in which the pulmonary valve, the valve that leads out from the right side of the heart to the lungs, is extremely small and essentially unformed.  Balloon valvuloplasty, in which a catheter is placed across the tiny valve plate and progressively larger balloons are inflated to enlarge the opening, can cause the valve to no longer be obstructive.  However, it can also cause the valve to leak.  It is possible that the valve is leaking, although I do not have this information.  Your cardiologist should be able to tell you whether the pulmonary valve is leaking, and whether it is enough of a leak to cause the right ventricle to be larger from the extra blood volume flowing backwards.  If the leak is moderate or severe, the right heart will likely not become normal in size.  However, if he has no symptoms with this, is able to exercise adequately, and has no rhythm abnormalities, this can be observed.  Eventually, he may require surgical placement of a valve in the pulmonary position to reduce the amount of leakage, if this is the cause.

Another possible cause of the enlarged heart can occur if there is decreased coronary artery blood flow to that area of the heart.  Patients with pulmonary atresia can have abnormal connections of the coronary arteries directly to the right ventricle that are dependent upon the very high pressures generated by the obstructed pumping chamber.  When the pressure is relieved by balloon valvuloplasty, decreased blood flow through the coronary arteries can damage the heart muscle.  Your cardiologist should be able to discuss whether this was a potential cause of the heart enlargement, as well.
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773637_tn?1327450515
Jeffrey R Boris, M.D.Blank
The Children’s Hospital of Philadelphia
Philadelphia, PA
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