20 month old with VSD and ventricular hypertrophy

[Rubys_Mom]

First, some background. My 20-month-old daughter weighs 27.5 lbs, is 32" tall, and is normal in growth and development.  The pregnancy was normal until her birth, where I had an enormous bag of water (1500cc).  She was born via emergency C-section (breech, difficult to get out), and weighed 8lbs, 4 oz, 19.5" at 38 weeks.

At her 6-month checkup, the doctor heard a murmur, and consequently tests (EKG and ultrasound) confirmed two VSDs between the lower chambers.  The septum was also a little thick.  So fast forward to her checkup this week, and not only are there no changes with the VSDs but the septum is a bit thicker now, and she shows left ventricular hypertrophy.  The EKG results:

EKG results: "Sinus rhythem - normal P axis, Ventricular rate 89-151
Condsider left Atrial abnormality - wide notched P waves.
Probably left ventricular hypertrophy. Q 56/II-aVF & 1 of S1/2, R6, S1R6

Her blood pressure was on the high side of normal, but the cardiologist said depending on how the next visit goes (on 2/11), we may need to consult a Renal specialist.  I'm worried sick!  What happens with a baby who has these problems?  What is causing the thickening of the septum and left ventrical?  Is my child going to have to have surgery, or do I have something worse to worry about?  

Thank you in advance for any information you can give me!

Melissa

[Cleveland Clinic]

I am not aware of all of the facts in this case, as I don't know why the doctor wants to consult a renal specialist. I am not, also, a pediatric cardiologist. But the major problem here is not the hypertrophy of the ventricles but the presence of the VSDs. The question is what kind of VSDs and what is the magnitude of the shunt; in adults we perform TEEs and RHCs to address these issues, and they may also be performed in infants, but since I am not a pediatric cardiologist I would't know exactly how these issues are addressed in infants.
Most infant VSDs do close spontaneously.

[Rubys_Mom]

The reason the cardiologist said we may need to consult a renal specialist is that her BP was on the highest end of the normal range.  Apparently, she's concerned about the possibility of her kidneys not functioning correctly, and causing an elevation in Ruby's blood pressure.  The VSDs are very small, and have not changed since 11/27/06.

Melissa

[Rubys_Mom]

I forgot to mention that at the time the VSDs were diagnosed, the cardiologist stated that blood from the lower right side was leaking slightly into the left side, which was not as much of a concern as if it was the other way around.  I'm just going by memory, so this is pretty much all the info I have right now.

Thank you for posting.  I do appreciate it.

Melissa

[momtofourboys]

Hi my son was 3 months old when he had his VERY LARGE VSD closed. he also had a hole on the upper part of his heart (ASD and another issue) these didn't require surgery however they stitched them close since they were in there already. the holes may take a while to close. my son also had the issue of the blood going the wrong way and he still does however not all of the time.. his BP at times can get a little high.
You little one will probablly be okay. Your doctor may just want to be on the caution side of things, which trust me that is way a head of where I am at. your daughter's weight is good, which means she is thriving so I wouldn't worry about the heart. my 4 year old is only 33 pounds and he was born at 8 pounds even.
good luck and I hope things work out okay..
by the way if she does for whatever reason, need surgery, she will be okay. Now and days with the way technology is, they are way ahead. As Cree Cree's cardiac surgeon said (his real name is christopher) I DO THESE SURGERIES ALL OF THE TIME I COULD DO IT WITH MY EYES SHUT.  
I know it is easier said then done when I say try not to worry, your daughter can sense your stress and it could put stress on her which isn't good for any little duffer.
Again good luck
Michelle

[Rubys_Mom]

Thank you very much for the good thoughts and the info.  Its just hard when your littlest one has something wrong with her heart, and you really don't know what to expect.

I have four other children, ages 10 (tomorrow!), 7, and 3.  I am doing my best to keep things as "normal" as possible, and give them a great Christmas.

(((BIG HUG))) to you and Christopher.

Melissa