Small muscular VSD

[Arvind123]

Dear Doc.
in 06/12/2009 my baby boy born after third day of birth peditrican foun a light abnormal voice from hear so he suggest for LD eco test after test found the my son have have small muscular VSD is present with left to  right shunt.pr.gr=20 mm of Hg.and Mild PH is present .PASP=40 mm of Hg. doctor suggest me after 4 to 4 month it will be filled  adn after 06 month again do the the test. pl. advise & give your idea how i can treat this matter.
one thing more my son have frequently sneezeing in 24 hours aprox 2 to 3.
please reply my query.

[Arvind123]

Thanks a lot doctor for your reply

[Jeffrey R Boris, M.D.]

Dear Arvind,

A ventricular septal defect (VSD) is a hole between the lower two chambers of the heart.  The “voice”, or murmur, that is heard is the turbulence of the blood going through the hole.  A small defect typically does not cause problems and frequently closes by itself (often by age 12 months), though it depends on where the defect is located in the ventricular septum.  I am not sure of the timing of the initial echocardiogram that you mention.  A peak gradient of 20 mmHg means that the pressure difference between the left and right sides of the heart is low, which is borne out by the elevated right sided pressures that you mention of 40 mmHg.  If this echo was performed soon after your son was born, this is probably normal for age, and will likely change to a higher gradient across the defect with lower right sided pressures.  However, if it was done months afterward, it would be worrisome since the right sided pressure is still elevated when it shouldn’t be so.  

Sneezing is not a problem for the heart, and is a common way for infants to clear their nasal passages.  However, since I am not able to evaluate your son, you should check with your pediatrician to ensure that there is nothing else wrong.