vsd

[shado]

Hi, My Grandson was born July 4th with Downs. He has no murmur but has a small hole and a 4 mil vsd. Cardio put him on .25 of lasix daily. He seems to have a tummy ache and several bm's during the day. This young man never wants to sleep and only does about 2-4 hrs at a time. He is very active being so young turning on his side and pushing with his legs.The Dr. said if it was 3 mil it would be better but  since it is a 4 he may require surgery later. Does this sound right as he is the only Pediatric Dr. in town. He only weighed 5# 10oz at birth and drinks 30 to 60 cc every 3 hrs.
Shado

[shado]

Thank you for the reply. The Dr  indicated he may need surgery as 3 mil hole would be no problem but a 4 is too much. The first x-ray they took was clear and he has ordered another for this week. The baby has no sweats and eats well so it is a little confusing to me.
Thanks again. Shado

[Jeffrey R Boris, M.D.]

Dear Shado,

I don’t understand everything that you are telling me in your statement.  Assuming that your grandson was born at term, a 4 mm VSD is a small hole and shouldn’t necessarily be causing problems.  Therefore, I am not sure that it is definitely a small defect.  The signs for which his parents should be watching include getting out of breath with feeds or getting sweaty with feeds, which would be signs of what we call congestive heart failure (CHF).  If he is eating well and growing well, and is not breathing too hard (faster than 60 times per minute), then he should likely not require surgery.  Lasix is a diuretic that can help if he does have symptoms of CHF, but is not necessary in its absence.  Without evaluating your grandson, I cannot tell if he has CHF, or not, and am not sure what is truly required for him.  His cardiologist may want to see him again to re-evaluate him, and may be able to tell you at that time what the best plan is.