teenage daughter with blue feet and mottled legs

[mimic]

Over the last few months, we've noticed that my 15 year-old daughter's feet are often dark blue and occasionally her legs are also mottled. Her father has a bicuspid aortic valve which was diagnosed when he was 40. Her 20 year-old brother had a VSD and ASD, both corrected surgically when he was 7 months old, though he suffered neuro complications during the surgery. I have taken her to the doctor who checked pulses in her feet with a doppler when she couldn't palpate them. She thought they were diminished and ordered blood work (which has since shown a mildly elevated red blood cell count), an echo cardiogram and a NIVA, which have not yet been scheduled. I am, of course, very worried about my daughter, though outside of the obvious circulatory problems, she seems quite healthy.

My question is this: While pregnant with my daughter, I had a level III ultrasound and -- based on my son's heart defect -- great attention was paid to her heart. No defect was found. Also, she has been asymptomatic for all these years and her blood pressure is normal. How likely is it that she has a serious heart defect that was missed? And what other problems should we be considering?  

Thank you for any information you can provide.

[Douglas Bogart, MD]

With your family history of congenital heart disease your daughter should be very carefully evaluated for a coarctation of the aorta or a patent ductus arteriosus.  She should be seen by a cardiologist.

[Momto3]

Best of luck to you and your daughter.  Sounds like "mom" is on the trail.  Hope you find the answers and that all turns out to be well for your daughter.

[mimic]

Her glucose was normal -- at least at the time of the blood test. We considered diabetes, because my father was a type I diabetic, and my brother, diagnosed at age 11, is too. The doctor assured me it's not that. Thanks for the input though.

[Momto3]

Any chance of a high glucose?  The comment about her legs brought diabetes to mind.