1 yr old with heart murmur blue lips and rapid breathing

[HelenH31]

Hi
I took my one year old son to the drs yesterday, it was discovered that he has a pansystolic murmur and has been refered to the peads.  He also suffers from blue lips and finger tips, particularly when he is cold.  Also has very rapid breathing.  He has been given about 10 different types of antibitiocs in his 1 year of life as the drs always put it down to a chest infection.  They never work abviously.  Lots of things are coming back to me now that make me wonder if they are connected.  He is a very pale baby with white blonde hair and blue eyes, people comment on how pale he is but i always put it down to his colouring, also when he was a newborn his cry was very unusual?  Might not be connected but i though i would mention it too.  I have borrowed and oxygen saturation reader today and his Sp02 is 97% and his pulse is 168-170 bpm.  He wasnt being active at the time.  Do you think I should wait for the appointment or take him straight to the hospital.
Thanks
Helen

[Marie M Gleason, M.D.]

If your son is one year old and has a resting heart rate of 170 beats per minute (without a fever) that is abnormally fast.  If the oxygen saturation is 97% that is normal, and as such the "blueness" is likely due to what is called acrocyanosis.  This means that the lips and nail beds look dusky when the person is cold.  Also, the blood vessels around the mouth and eyes can be more easily seen in fair skinned children.  A pan-systolic murmur can represent either a hole between the lower pumping chmbers called a ventricular septal defect (VSD) or a leaking heart valve, usually the mitral valve.  If either of these heart problems is of a significant degree it can make increased work for the heart, and one may have rapid breathing.  It sounds like your child does need cardiac evaluation and testing.  An electrocardiogram, chest x-ray and an echocardiogram sound like they are indicated given these symptoms.  As far as acuity of the evaluation, it sounds like your primary doctor did not feel that an emergency was present, but you should recontact that doctor about your concerns and make a plan for getting the evaluation accomplished.

[Marie M Gleason, M.D.]

That sounds much better to have a heart rate in the 130's.  I agree with your plan to take him back to the doctor to clear up your questions.

[HelenH31]

Thank you so much for your reply.  I checked his pulse while he was asleep and it was 130bpm is that ok? I have looked on google but I am getting such different answers.  I am going to take him back to the drs tomorrow.  His lips go blue when he is out in the cold but i always wrap him up so well so he shouldnt be that cold, he has a snow suit and blankets and is in his pram.  It is very worrying.  
Thanks again for your fast response.