Manual The heart of a child: what families need to know about heart disorders in children

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Table of contents

Other heart problems need treatment with medicine, procedures, or surgery. Your doctor will talk to you about your treatment options, or the treatment options for your child. Many babies with heart disease need medicine to make their heart stronger or to prevent other problems. Some babies need to have surgery.

Some heart problems have to be fixed as soon as the baby is born. Other problems can wait until the child is older. Sometimes the repair takes more than one operation. After surgery, your baby will probably stay in a neonatal intensive care unit NICU for a few days. There the doctors and nurses can keep a close watch. Many children are back to normal just a few days after heart surgery. Try giving smaller amounts of milk at one time.

Then feed the baby more often. Your baby may need more food because a heart defect makes the heart work harder. This makes your baby burn more calories — just like you burn more calories when you exercise. Some people who have congenital heart problems are at a higher risk for other heart problems, including:. Even if the problem is fixed, your child will need to be monitored for heart problems for the rest of their life.

Caring for a baby or child with a heart problem can emotional and stressful. You need all of the information and support you can get. Connect with parents of other children with a heart problem. They can help you reduce stress, anxiety, and depression. This article was contributed by: familydoctor. This information provides a general overview and may not apply to everyone.

Talk to your family doctor to find out if this information applies to you and to get more information on this subject. Newborn babies can receive screening in the hospital. The required tests vary by state and have pros and cons. Congenital adrenal hyperplasia CAH affects your adrenal glands, which produce hormones.

Learn about the symptoms and treatment. It is common and…. Visit The Symptom Checker. Read More. Acute Bronchitis. Fever in Infants and Children. Shortness of Breath. Table of Contents. What is congenital heart disease? They could include: heart valve defects a hole in the heart defects in one of the chambers heart muscle abnormalities. Symptoms of congenital heart disease. The symptoms depend on the type of heart problem. Many people have no symptoms. In older children or adults, congenital heart problems may cause symptoms such as: heart murmur shortness of breath fatigue during exercise.

What causes congenital heart disease? Some risk factors for congenital heart defects include: Family history. The risk is higher if a parent or sibling has a congenital heart problem. How is congenital heart disease diagnosed? An ECG shows the heartbeat as a line tracing. It measures electrical activity in the heart. Pulse oximetry. Chest X-ray. At other times, however, the interruption is complete and the upper and lower chambers have no electrical connection.

The lower chambers pump independently of the upper chambers. This can cause problems if the heart rate of the lower chambers is too slow. Symptoms of tiredness, dizziness, headache and fainting can occur. If the rate is very slow, the heart pump function may not supply enough blood to the body.

Then the heart becomes an inefficient pump and congestive heart failure can result. When heart block is detected in a newborn, its exact cause may not be known, as in most types of congenital heart defects. Heart block usually occurs in hearts that are otherwise normal. Surgery on the heart can't fix the problem.

However, if the infant's heart rate is too slow and symptoms develop, a pacemaker may be needed. Pacemakers are small battery-powered electronic devices, a little bigger than the size of two silver dollars, that remind the heart to beat at an appropriate rate to prevent symptoms of the very slow heart rate.

These devices are surgically implanted under the skin in the upper abdomen or chest. A wire connects the pacemaker generator to the heart itself. Infants with pacemakers can develop normally and lead normal lives. Later in life, they'll need to avoid some types of contact sports like football and wrestling to prevent damage to the pacemaker system. Some children do not need pacemakers until they are teenagers. These pacemakers have their wires placed through veins leading to the heart and connected to the pacemaker in the upper chest under the collarbone.

At times, a mother with an infant who has heart block may unknowingly have a condition that causes problems with some of her own body's tissues, like skin and joints. An example of one of the types of this condition is called lupus erythematosus. Her condition can affect the developing fetus by interfering with the infant heart's conduction system.

The infants themselves don't develop the skin and joint problems.

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Since mothers having a newborn infant with heart block may develop skin and joint problems themselves later in life, they should notify their physicians and consider having special testing. I was recently told that my 6-year-old daughter has a murmur but that it is an " innocent murmur " and I have nothing to worry about. My sister was born with a hole in her heart and had open heart surgery and now is on medicines because her heart is weak. I am scared that my daughter has something serious. Is there such a thing as an innocent murmur? If so, what is it?

Should I be more worried about my daughter because my sister has congenital heart disease? Innocent heart murmurs are sounds made by the blood circulating through the heart's chambers and valves or through blood vessels near the heart. They're sometimes called other names such as "functional" or "physiologic" murmurs. Innocent murmurs, also called functional or normal murmurs, are very common during infancy and childhood.

In fact, it is estimated that at some time in their lives most children will have an innocent heart murmur. There are a few types of innocent murmurs, but all represent the normal sound of blood as it flows from the heart into the main blood vessels of the body or lungs. Normal murmurs are usually diagnosed by the typical sound heard with a stethoscope during a physical examination. Some murmurs require additional tests, such as an electrocardiogram ECG or echocardiogram Echo to distinguish them from much less common abnormal murmurs. Heart abnormalities can on rare occasions run in the family.

However, if you do not have congenital heart disease and your sister is the only family member to be born with a heart problem, then your daughter is not at increased risk of having such a problem. Sometimes, when a doctor first hears the murmur through a stethoscope, he or she may want to have other tests done to be sure the murmur is innocent. After that, there's no need for a cardiac reevaluation unless the patient or doctor has more questions.

The child doesn't need medication, won't have cardiac symptoms, and doesn't have a heart problem or heart disease. A parent doesn't need to pamper the child or restrict his or her diet or activities. The child can be as active as any other normal, healthy child. When my son is sleeping, his heart rate frequently varies at 80, 60 and 40 with a few seconds pause; no color change is noted.

Is this an indication of any potentially serious problems? If so, a heart rate of 80 beats per minute would be within the realm of normal. The heart rate will go down during sleep and it will vary from time to time, most often with his breathing pattern.

My sister was told her daughter needs a heart transplant. Can you provide me with information about this? Heart transplantation involves replacing a failing heart with a new one donor heart. Children undergo heart transplantation for two primary reasons -- a congenital heart defect or severe malfunction of the heart muscle. Heart transplantation is considered when there are no other medical or surgical options.

The hearts are donated from someone who has suffered an injury resulting in death of his or her brain, but not the other vital organs and whose family has agreed to make the heart and other organs available for donation. Many children who receive heart transplants live years longer than they otherwise would have and have an excellent quality of life. The waiting time for a heart can range from days to months even more than a year and depends on multiple factors including size, blood type, and whether the patient is hospitalized on intravenous heart medications. Patients who receive a heart transplant need to be on medications to prevent their own body from attacking the heart rejection.

Unfortunately, these medicines have many side effects, including making the body more susceptible to a dangerous infections, damaging the kidneys, and even cancer. Frequent visits at least every three months to the transplant cardiology team are required for close monitoring. My 8-year-old daughter was just diagnosed with ventricular hypertrophy. When she was 2, she was diagnosed with a heart murmur and I was told that she would probably outgrow it.

Can you shed any light on how this could have happened? The murmur your child had at age 2 likely had nothing to do with her current diagnosis. Murmurs, or "extra heart sounds," are very common in children and are usually "benign" or "innocent" murmurs. These extra sounds may arise from the thin chest wall and rapid growth seen in early childhood. You have been told that your daughter has "ventricular hypertrophy," which is a thickening of the heart muscle. This diagnosis can be suspected by an electrocardiogram, but needs to be confirmed by an echocardiogram read by a pediatric cardiologist.

Ventricular hypertrophy can occur from stenotic blocked heart valves, high blood pressure, or can be the result of a condition called hypertrophic cardiomyopathy. Hypertrophic cardiomyopathy is caused by several genetic defects resulting in an abnormally thick heart muscle. This disease can run in families or be the result of a new genetic mutation.

It can result in poor heart function, heart failure, heart rhythm problems and in some severe cases, can cause passing out or cardiovascular collapse. If ventricular hypertrophy is confirmed by further testing, it is important that the cause be determined and the appropriate treatment and medical checkups be followed. My son was born with Hypoplastic Left Heart Syndrome. He has had two operations and we have been told that he will need another one. Although his doctor has explained what he has to me, I still don't understand what is wrong with him and why he is blue and can't keep up with other children his age.

Will he always be like this? The right ventricle normally pumps blood to the lungs, while the left ventricle normally does all the work to pump the blood to the rest of the body. In your son's case, the primary problem is that the left ventricle did not develop properly during the pregnancy and the right ventricle has to do all the work.

The first two operations result in the blue blood from the upper half of the body going directly to the lungs and the rest of the blood mixing together and going to the body. The blue blood without oxygen returning from the body mixes with the red blood returning from the lungs. The mixed blood is then pumped to supply the body, causing him to appear blue. This may allow him to better keep up when participating in physical activities. Her cardiologist said it would not need to be repaired. Recently, I was talking with some parents in a local support group. They said kids with congenital heart defects need to take antibiotics before going to the dentist to keep them from getting endocarditis.

Congenital Heart Disease

I called her doctor, and she said that our daughter did not need antibiotics. Should I tell her dentist that she needs antibiotics? What are the antibiotics for? What is endocarditis? Most children with congenital heart defects are at an increased risk for developing bacterial endocarditis , an infection of the lining of the inside of the heart or the heart valves this lining is called the endocardium.

Bacterial endocarditis also called infective endocarditis occurs when bacteria in the bloodstream bacteremia lodge on abnormal heart valves or most structural abnormalities of the heart. Certain bacteria normally live on parts of the body, such as the mouth and upper respiratory system, the intestinal and urinary tracts, and the skin.

Some surgical and dental procedures cause a brief bacteremia. Although bacteremia is common following many invasive procedures, only certain bacteria commonly cause endocarditis. For many years the American Heart Association recommended that children and adults at increased risk for endocarditis take antibiotics before certain dental and surgical procedures. This was done because it was thought that when someone was having one of the dental or surgical procedures that can cause bacteremia, antibiotics could be given to prevent the bacteria from surviving in the bloodstream.

However, the AHA made major changes to their guidelines in After they reviewed all of the scientific evidence on the causes and prevention of endocarditis, they concluded that the prophylactic dose of antibiotics given before dental and surgical procedures prevent very few, if any, cases of endocarditis. There is also some risk involved with taking antibiotics. Therefore, the new guidelines say that antibiotic prophylaxis should be reserved only for those children and adults who have the greatest risk for a bad outcome if they get endocarditis.

Patients with congenital heart disease who are at the greatest danger of bad outcomes from IE and for whom preventive antibiotics prior to a dental procedure are worth the risks include those with:. Except for the conditions listed above, antibiotic prophylaxis is no longer recommended for any other form of congenital heart disease.

Other people who are still recommended to take antibiotics before most dental procedures include those who have a prosthetic heart valve, those who have previously had a case of endocarditis, and a cardiac transplant patient whose heart develops a problem in a heart valve. Most of these situations would be in adults, but some could be children. Furthermore, the AHA emphasizes that for anyone at increased risk for endocarditis, good oral health and hygiene by regular tooth brushing, etc. My daughter was born with an interrupted aortic arch and a double outlet right ventricle.

Please explain these heart defects to me. What are my chances of having another child with the same condition? Your daughter was born with several complicated heart defects that involve problems with the heart pump as well as both main blood vessels that supply the body and lungs. In this condition, the main blood vessel to the body aorta is interrupted in the area of the blood vessels that supply the upper body.

In addition, instead of the lung artery pulmonary artery and aorta coming out of separate chambers, both arise from the right-sided ventricle. There is also an associated hole ventricular septal defect or VSD between the pumping chambers. This heart defect requires surgery during infancy. After surgery, your child will need to be seen by a congenital heart disease specialist for the rest of her life. This combination of heart defects may be associated with a genetic syndrome called "DiGeorge Syndrome," which may also include other defects such as abnormal function of the immune system as well as the gland that controls calcium in the bloodstream.

This syndrome is caused by a genetic defect on one of the chromosomes, chromosome 22q The heart defects may also occur separately and can also be associated with a similar defect on the same gene. This gene defect can be detected by a specialized genetic test FISH or fluorescent in situ hybridization. This test can determine if one of the parents also has this genetic defect or if this is a new defect gene mutation. The results of this testing will help determine the risk of having another child with the same or a related heart defect.

If neither parent has this gene defect, the risk of having another child with congenital heart disease is 4 percent to 6 percent. But if one parent has the gene defect then the odds of having a child with a similar gene defect may be 50 percent. These issues should be discussed with your cardiologist or genetics specialist. My obstetrician detected an irregular heart rhythm during a regular visit today. I am 24 weeks pregnant and everything else has been fine.

What is an irregular heartbeat and what does it mean for my unborn baby? Will this problem go away before my baby is born? Do I need to take medication? An irregular heart rhythm is usually benign, but your obstetrician may refer you to a pediatric cardiologist for a fetal echocardiogram to better define the heart rhythm.

The normal fetal heart rate is between and beats per minute. The heartbeat is usually regular with only a little variation in the heart rate. Each normal heartbeat begins from the top part of the heart atrium , followed by the bottom part of the heart ventricle. The bottom part of the heart is what causes blood to leave the heart and make a sound on the heart monitor. The most common cause of an irregular heart rhythm is when the top part of the heart beats too early premature atrial contraction, or PAC.

Sometimes this premature beat is transmitted to the bottom part of the heart; other times the communication between the top and bottom part of the heart is blocked after a premature beat. An early beat that is transmitted or blocked will cause an irregularity in the heart's rhythm. These premature atrial contractions are very common in the second half of pregnancy and usually don't cause any problems.

They may persist after the baby is born, but usually go away by one month of life.

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Medication is typically not necessary. Irregular heart rhythms can cause problems in a small percentage of cases if multiple consecutive premature beats occur. When this happens for a long enough period, it's called tachycardia fast heart rate. If there are any signs of damage to the fetal heart, it may be recommended that you be hospitalized while beginning the medicine. If you are put on medicine, it is likely the baby will need to take a similar heart rhythm medicine after birth.

Another cause of slow fetal heart rate is a condition called heart block, or atrioventricular AV block. This is more commonly seen in mothers with lupus and other related autoimmune conditions. Most fetuses with tachycardia have a good prognosis if the heart is structurally normal. Some fetuses have a pattern of frequent blocked premature contractions resulting in a low heart rate bradycardia.

This does not usually cause any problems to the baby as long as the heart rate remains above 60— Some fetuses with premature atrial contractions can have bradycardia on one visit and develop tachycardia later on. An irregular heart rhythm is not usually worrisome in the fetus, but should be followed closely by your obstetrician and pediatric cardiologist. I was told that my daughter has Kawasaki Disease.

Is it serious? Will she get better and lead a normal life? Kawasaki Disease KD is an inflammatory disease of unknown cause. Some evidence suggests it may be caused by an infection. KD usually occurs in children, and is very rare in adults. Children with KD have high fevers lasting at least five days, along with a variety of other symptoms.

These may include conjunctivitis inflammation of the inner eyelid and whites of the eyes , rash, swollen lips and tongue, enlarged lymph nodes, and reddened, peeling hands and feet. There is no specific test to prove that a child has KD. The diagnosis is made based on a characteristic illness pattern, and the exclusion of other diseases, such as strep throat. Most children with KD are very irritable.

Children with uncomplicated KD generally recover without treatment. However, serious complications can develop if the disease involves the coronary arteries. If the enlarged coronaries become blocked from blood clots, then the heart muscle supplied by the coronary artery suffers from a lack of oxygen.

This can cause chest pain known as angina or a heart attack. Some children require medicine to dissolve or prevent blood clots. Some require urgent coronary artery bypass surgery. The dilation of the coronary arteries and the risk for blockage can be permanent.

Treatment with an intravenous medicine known as gamma globulin can help reduce this risk. Children with known or suspected KD are generally admitted to the hospital and treated with intravenous gamma globulin. They are also usually given high doses of aspirin until their fever goes away.

Afterward, a low dose of aspirin is continued to prevent blood clots. An echocardiogram is performed to find out if there is any involvement of the coronary arteries. Children who remain with ongoing fevers, or who have coronary involvement, are treated more aggressively. These children may receive additional doses of gamma globulin or be treated with steroids or other medicines. Whether your daughter will get better and lead a normal life depends partly on how well she responds to treatment.

Most importantly, in depends on whether she develops coronary artery aneurysms. Most children who are treated with gamma globulin within 10 days of illness recover completely. Those without giant aneurysms usually have normal health after they recover. However, children with giant aneurysms usually require ongoing treatment to prevent blood clots. They often have significant physical limitations. These children require close medical follow-up and may require surgery.

My pediatrician suspects that my son has Marfan syndrome and has referred him to a pediatric cardiologist for evaluation. What exactly is Marfan and how does it affect the heart? Marfan syndrome is a rare disorder; it affects one in every 5,, people. It usually "runs in the family," but your son could also be the first in your family with Marfan syndrome. Almost all body parts and organs function normally, and the brain is not affected.

Many historians believe that Abraham Lincoln had Marfan syndrome. People with Marfan syndrome are tall and thin, have long arms, legs and fingers, and tend to be double-jointed. They also are likely to have curvature of the spine and an unusually shaped breastbone. Patients with Marfan syndrome tend to be near-sighted, and some can develop more severe vision problems due to shifting in the position of the lens of the eye.

Your son was referred to a pediatric cardiologist because 60 percent to 80 percent of people with Marfan syndrome develop enlargement of the first portion of the aorta -- the main artery that takes blood from the heart and distributes it to all parts of the body. For this reason, an echocardiogram helps to confirm the diagnosis of Marfan syndrome. Problems from enlargement of the aorta in children or teenagers are very rare.

Later in life, many people with Marfan syndrome develop so much enlargement of the aorta that open-heart surgery may be needed to replace the first portion of the aorta before it ruptures. Therefore, if your son is diagnosed as having Marfan syndrome, echocardiograms will probably be needed every year to check on the growth of his aorta. Some doctors will prescribe a medication called a beta-blocker for patients with Marfan syndrome. By relaxing the heart and slowing the heart rate, beta-blockers may slow down the rate at which the aorta dilates.

A new drug treatment for Marfan syndrome is currently being tested in children and adolescents with Marfan syndrome and dilated aorta. This study is sponsored by the National Institutes of Health and information about it can be found through the Pediatric Heart Network website link opens in new window and at www.

Diagnosis During Pregnancy

You can find a lot more information at the National Marfan Foundation website link opens in new window. My year-old daughter has been complaining of a headache and dizziness for a week. Please tell me what this condition is. What should my daughter avoid? MVP is usually a very benign condition that occurs in children and adults. The mitral valve prevents blood from going backwards by closing when the main pumping chamber of the heart left ventricle is squeezing or contracting.

Some times the leaflets of the mitral valve moves backwards a little during the contraction of the left ventricle. In most patients this causes a minor and insignificant amount of leakage and does not affect the function of the heart. Some patients with MVP may have a variety of symptoms such as palpitations, headaches, dizziness, or even fainting.

This aspect of MVP is not related to the severity of the valve leakage; in fact, it is most common in patients with minimal valve leakage. This condition is rarely dangerous but can be uncomfortable. Rare disorders such as thyroid disease, inflammatory diseases, and defects in the strength of heart vessels and valves may all be associated with MVP and can usually be easily diagnosed when they are present, because of other signs and symptoms. Reduction or elimination of caffeine containing food and drinks coffee, soda, chocolate is often helpful in making the headaches, dizziness and palpitations go away.

Some patients may require a medication to offset the effect of the adrenalin. These medicines, called beta-blockers, will lower the heart rate and blood pressure, and help to reduce or eliminate symptoms. Almost all patients with MVP can participate in sports without restrictions. Although many physicians may suspect MVP when listening to the heart, echocardiography ultrasound of the heart is the only way to definitively diagnose MVP. It is also important to know that MVP is the most over-diagnosed heart condition and should only be made and treated by an experienced pediatric cardiologist.

I have been told that my 6-year-old daughter has pulmonary hypertension. What does this mean? Is it the same as the hypertension that has been diagnosed in my mother? Pulmonary hypertension is a condition in which pressure in the blood vessels in the lungs is higher than normal. This is different from systemic hypertension where pressure in the blood vessels to the body is higher than normal. Systemic hypertension is a common condition especially in people as they age. It is diagnosed by taking a blood pressure in the arm. Systemic hypertension is usually successfully treated by oral medications.

In contrast, pulmonary hypertension is a rare condition in both children and adults. Patients usually present to the doctor with symptoms of fatigue, chest pain, difficulty breathing with activity and episodes of fainting or nearly fainting. As you can imagine, these symptoms are difficult to get a handle on, especially in infants.

Thus, pulmonary hypertension is often diagnosed late, after the patient has had vague symptoms for some time. Pulmonary hypertension can be diagnosed by echocardiography cardiac ultrasound , although cardiac catheterization is often recommended to confirm the diagnosis and as a way to better understand the cause. There are two broad classes of pulmonary hypertension: those without any obvious cause termed idiopathic and those caused by or occurring with other diseases. Diseases that can cause pulmonary hypertension include:. When possible, the best treatment for pulmonary hypertension is treating the underlying disease.

When this is possible, the pulmonary hypertension may resolve or at least improve. In situations where treatment of the underlying disease does not improve the pulmonary hypertension and in situations of idiopathic pulmonary hypertension, medications are available. In the past, these medications were only intravenous and often involved long-term intravenous therapy.

Inhaled and oral medications have more recently become available.


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Although rare, lung transplantation has been used successfully in severe cases. For more information on pulmonary hypertension, visit the Pulmonary Hypertension Association's link opens in new window website. We were told that our child has pulmonary valve stenosis. His heart valve doesn't open completely. What can be done to fix the valve? The pulmonary valve is like a one-way swinging door on the right side of the heart that prevents back flow of blood from the lungs to the heart.

Sometimes, during heart development, the valve does not form properly. If the valve is tight stenosis , the right side of the heart needs to work harder to push blood through the valve to the lungs. Depending on how tight the valve is, it may or may not need to be fixed. Your congenital heart specialist can discuss this with you. If the valve is only mildly tight, it can be left alone and may get better as your child gets older.

However, if the valve is tight and causes the heart to work harder than it should, it may need to be opened with a small balloon using a special tube catheter placed into the heart from a blood vein as part of an interventional catheterization procedure. If the valve is very tight or malformed, it may need to be surgically opened or replaced. The normal heart has two pumping chambers or ventricles. These defects are often called hypoplastic left heart or hypoplastic right heart.

Hypoplastic right heart includes a wide range of defects with a small or absent tricuspid valve or pulmonary valve the valves on the right side of the heart. In addition, a single ventricle occurs if there is no partition between the two pumping chambers. These defects can result in severe heart failure not enough blood to the body or severe cyanosis not enough blood to the lungs. All of these defects require a common treatment designed to ensure blood flow to both the lungs and the body. Sometimes this requires limiting blood flow to the lungs and creating a new blood vessel to provide blood flow to the body.

Other times, operations are required to ensure blood flow goes to the lung arteries. Ultimately, most babies with single ventricle need two or three operations that result in the channeling of blue blood unoxygenated to the lungs and red blood oxygenated to the body. There are good surgical options for most babies with single ventricle and many children with this condition can do most normal childhood activities. Your pediatric cardiologist can give you the best information on the specifics of your child's condition.

My year-old daughter had a hole in her heart repaired when she was 1. She has been healthy since then. Will she be able to participate in sports? Questions about athletic participation in patients with heart problems are frequent. There are a wide variety of cardiac defects, surgical repairs, and sports. It is best for you to discuss with your pediatric cardiologist as to whether your daughter needs any restrictions from sports.

This is particularly true if she wants to eventually participate at the high school or college level. Most children who have relatively simple cardiac defects, and who have had a good result after catheter or surgical repair can participate in at least some, if not all, athletic activities. Other children may have heart conditions that warrant some restrictions. Patients that are taking anticoagulants drugs that decrease blood clotting should also use caution and check with their physician about sports participation.

We'd like to have another child. Will our second child also have congenital heart disease?

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Congenital heart disease is the most common birth defect. About eight out of every 1, babies or 0. For a couple who's had one child with DTGA and has no other family members with transposition, the chance of having another child with DTGA increases slightly to about 18 in 1, or 1. This is also about the same chance of this baby being born with a form of congenital heart disease other than DTGA.


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  5. This gives a greater than 98 percent chance that the baby will be born with a normal heart. If, however, other family members first-degree relatives have DTGA, other forms of transposition, or other forms of congenital heart disease, the chance that the baby will be born with DTGA may be higher. Transposition rarely runs in the family.

    We don't know why congenital heart defects like DTGA occur. The reason is presumed to be genetic, although a specific gene for DTGA hasn't been identified yet. With regard to DTGA, some evidence exists that multiple genes as well as other factors may be involved. Because you've had one child with a congenital heart disease, it may be helpful for you to have a fetal echocardiogram between 18 and 20 weeks gestation during your next pregnancy.

    This specialized ultrasound is done by a pediatric cardiologist and shows the developing heart. It should be able to exclude most forms of significant heart disease. My 4-year-old son was evaluated for a heart murmur today and underwent an echocardiogram. The doctor told me he had mild tricuspid valve regurgitation. Should I be worried? The tricuspid valve is one of four heart valves in the heart. This valve prevents blood from leaking backwards from the right ventricle the chamber of the heart that pumps blood to the lungs when this chamber squeezes. Almost all children undergoing echocardiography ultrasound of the heart have a little bit of tricuspid valve leakage or regurgitation.

    This is often detected because newer echocardiography machines have technology sensitive enough to pick up a wide variety of normal signals from blood moving through the heart. Mild tricuspid valve leakage, in the absence of any other heart problems, is considered to be a normal finding and nothing to worry about. The size of the hole is about 2 mm. Is this considered large or small, and what are long-term and short-term effects of VSD? A ventricular septal defect VSD 2 mm in diameter is considered small.

    Because it is small, one would not expect your baby to have any problems. This VSD will likely close completely as your baby grows, depending somewhat on the precise location of the hole. This could occur quite soon within months or take a few years. In general, a VSD that has not closed by about age 5 will not close spontaneously.

    VSDs that are very small do not become big as babies grow. Two complications from small VSDs are worth knowing about, both relatively rare. First, there is a small risk that a child or adult with a small VSD will develop an infection in the heart endocarditis. These infections are bacterial and can occur after events when bacteria are in the blood.

    The other complication from a small VSD depends on the precise location of the hole.

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    People with a VSD immediately below the aortic valve the valve at the exit from the left side of the heart to the body have a small chance that one of the leaflets of that valve may start to sag towards the hole over time. This rarely happens, but when it occurs, can lead to leakage of the valve. For the rare occasion that it does, your physician might recommend surgical closure of the small VSD to prevent further problems with the aortic valve. My 8-year-old son complained of chest pain and rapid heartbeat while taking a shower. This happened twice. He was on Flovent and Singulair for asthma.

    His doctor assures me that the medication had nothing to do with the chest pain. My son had an EKG and the pediatric cardiologist said it showed a wandering pacemaker and no further evaluation is necessary. Should I get a second opinion? The diagnosis of wandering pacemaker refers to a type of heart rhythm with normal variations in heart rate. The pacemaker is an area of the heart responsible for initiating the heartbeat.

    It's normally located in the upper part of the right atrium the upper right chamber of the heart. Sometimes the wandering pacemaker can move from the high right atrium to the low right atrium. Chest pain can be associated with an asthmatic condition. Some asthma medications can also cause a transient increase in heart rate, but the medicines your son is taking generally don't do this. Rarely, patients may experience a heart rhythm problem called tachycardia an abnormally fast heart rate. A transtelephonic EKG monitor is a device that can be used when symptoms occur.