Pediatric Heart Expert Forum
small vsd
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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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small vsd

my grand daughter had her 1 year follow up apt for a small vsd heart murmur.  We asked her doctor if a small vsd can enlarge and we were told NO; however after the doctor listened to her heart she sent her for a ultrasound.  When we sat with her after the test we were told that it appeared to be dialated and may need to be closed through a catherization.  We were not prepared for this news therefore we were speechless and didnt ask many questions.  I want to know what does "dilated mean" and is this something that we need to worry about?
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773637_tn?1327450515
Dear Mom,

As you may expect, dilated means larger.  I'm not sure why the VSD would be felt to be larger, unless its size was misjudged initially, which can certainly happen quite easily in the newborn period.  However, it is also unclear from what you are saying exactly is dilated.  It could be the defect, but more likely, it's the left ventricle and/or left atrium.  This happens when there is extra blood volume recirculating through the defect from left to right and returning from the lungs again to volume load the left side of the heart.  But, if your granddaughter is doing well, is growing well, and does not have evidence of congestive heart failure (getting out of breath easily or sweating easily), she may not need to have the defect closed.  Without evaluating her myself, I cannot say for sure what needs to be done and if this is truly a concern, or not.  If there is discussion of an intervention to close the defect, it is certainly reasonable to get a second opinion regarding this big decision.
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773637_tn?1327450515
Jeffrey R Boris, M.D.Blank
The Children’s Hospital of Philadelphia
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