vsd murmur

[raiqa]

I have an 18 month old baby, whom was diagnosed with a VSD murmur at the age of 6 weeks. He has been assesed by a cardiologist and i was told to take him for a follow up check up 1 year later. The murmur is very loud and found between the 2 large chambers of his heart.He once did have difficulty breathing and had to be rushed to the hospital and i am not certain if the murmur had caused the shortness of breath.  Please advise me exactly what steps i should take in order to treat this VSD murmur?

[Jeffrey R Boris, M.D.]

Dear Raiqa,

Just to clarify some terms for other people who might be reading this.  A murmur is the term that we use for a sound that we can hear with a stethoscope.  Our job as cardiologists is to determine whether that murmur, or sound, is associated with a heart defect or is a “normal” or “innocent” murmur.  The murmur is caused by turbulent blood flow for some reason.  Normal or innocent murmurs are associated with normal turbulence and have no heart defects; they're very common, occurring in 2/3 of all children.  Your child has a ventricular septal defect (VSD) which, as you stated, is a hole between the two pumping chambers of the heart, or the ventricles.  The murmur associated with it is the sound that someone can hear associated with the turbulent blood going through the hole.  This is not a normal murmur, as it is associated with a defect.  The defect can be small, medium-sized, or large.  The size of the defect can have a significant impact on what kind of clinical symptoms, follow-up, and need for intervention is called for.  From your description, it is difficult to tell from your child’s history and previous evaluation how big the defect is.  However, I would be happy to give you some general information about it.  Obviously, this information doesn’t substitute for your doctor’s evaluation of your child’s heart, but can hopefully direct you.

The size of the VSD can be associated with the “loudness” of the murmur, although it can also fool you.  Just like putting your thumb across the end of a garden hose with water coming out of it, the turbulence can increase and, thus, the loudness of the “murmur”, as the hole actually gets smaller.  Meanwhile, we do see more problems in children who have medium-sized or large defects.  Some of those problems can be difficulty with growth, getting out of breath easily with activity, or sweating with activity more than the average child.  In infants, nursing or bottle-feeding can be like a stress test and can cause babies to get out of breath or get sweaty while they’re feeding.  We can also see frequent lung infections because of the bigger defects.  I think it would be important for you to have your child seen and to get a sense of how big the defect is.  If the defect is medium-sized or large, the defect may need to be closed with surgery.  However, if it is small, it may not need to be closed at all and may not cause any complications.  

It is important for you to feel comfortable with what is going on with your child’s heart defect and how it will affect him, if at all.  Don’t be afraid to ask questions of your cardiologist and to make sure that you are happy with the response.  If you are still not sure or satisfied, you can always seek a second opinion.

[momtofourboys]

My now 5 year old was born with a very large VSD he had a 6/6 murmur. the doctor right from the day we found out he was 3 days old when we found out, told us this would have to be surgically corrected in time he can't say when but not right at the moment. he was 3 months old when he had to have it done. the hole in the bottom part of his heart was large his heart then was a size of a walnut and the hole was the size of a dime according to the doctors in Boston He also had holes in the upper part of his heart taht were fixed, but they said if he didn't need the other one to be fixed they wouldn't have corrected the upper ones.
I have a question and I am NOT trying to scar you, but has your child's cardiologist given you a list of what to look for if he is headed for trouble? I would also ask for the winter months, if he hasn't gotten it yet for the synagsis shot this helps with premature and cardiac babies lessen the effect of RSV it won't prevent it but will help lessen the effect.
If you need the sings just ask I have them. is he on a special calorie diet? Chris was and that was just nasty looking
Good luck
Michelle

[tatorbug40]

My DD had a VSD murmur, hers was very small, but her cardiologist had her come back every 3 months for the first year, and yearly after that.  At 2 years old, hers had completely closed on its own---  our neighbors daughter just had surgery this past year (now 5 years old) to close hers, and she did great!!!  She was back running around a week later-  kids are amazing!  It is a worrisome thing,  but they can correct it-  I believe they try to wait until the child is a little older to do the surgery...  but I'd say you should look into a better cardiologist, or at least make an apt with the one you have and ask all of the questions you have, and if you don't understand something, ask about it...  they won't mind...  it is very confusing, and they should take the time to explain everything to you.... ours was great!!!  Good luck.