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2 small muscular VSDs in newborn babyboy

Hi Doctor,

My 15 day old baby boy is diagonised to have 2 small muscular VSDs of 2.5 mm and 1.5 mm in size. There is no symptoms except for a murmur heard through stethescope. The Echo report says:
Situs solitus - normal comnnection ;  
SVC/IVC to RA, Pulmonary veins to LA ;
Concordant atrio-ventricular and ventriculo-arterial connection ;
No TR.  No MR. ;
Laminar Flow in outflow tracts ;
No AR or PR ;
Normal size cardiac chambers ;
Good ventricular function ;
Two small muscular VSDs of 2.5 mm and 1.5 mm ;
Left to Right shunt ;
Gradient across 42 mmHg ;
2 mm PFO left to right shunt.
No PDA seen ;
Normal aortic arch ;
No evidence of coarctation ;
Pulsatile abdominal aorta ;
The birth weight of the baby is 3.35 Kg and in 15 days the weight went up to 3.85 Kg. No feeding problem seen.

My questions are :

1.   Does the presence of 2 small VSDs has the effect of a large VSD.

2.   How does the VSDs is going to affect the baby in both Short Terms & Long Term

3.   What are the precaustions to be taken by the parents

4.   What is the chance of spontaneous closure of both the VSds.

5.   What are the symptoms we should look for.

Humbly request you to have kindness to explain the queries.

Thanks in advance,

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773655 tn?1340656399
Small VSDs are very common in newborns.  There are MANY postings on this website on this topic of VSDs.  It is not the case that 2 small defects act as one large defect. These VSDs should not affect the baby clinically in the short or the long term, since they often get smaller or close spontaneously.  Parents do not need to take any special precautions, aside from the normal surveillance of newborns, making sure that the feeding and growth are normal. It would be unlikely for your baby to have any cardiac symptoms, but if there were symptoms, they would be: 1) poor weight gain, 2) difficulty feeding, 3) consistently breathing faster than normal.  Good luck.
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