Sunday, January 8, 2012

Cardiology with unexpected results

Yesterday, I brought Josiah to the cardiologist for a routine evaluation. 

At 12 wks gestation, we learned that Josiah had a hole in his heart (ventricular septal defect (VSD)).  At wk 18 gestation, we were told that the hole had closed on it's own.  Just to be sure, we made an appt at an Advanced Fetal Care Center.  There, they performed another ultrasound and confirmed that no holes were present.  We were thrilled.

At birth, a heart murmur was detected but was gone the next day. 

Approximately 3 wks ago, the pediatrician detected the heart murmur again.  He referred us to the cardiology clinic affiliated with the Children's Hospital.  Given the previous ultrasounds and EKG's (which all looked good), we were not concerned.

As a side note, Josiah developed a respiratory infection about 10 days ago.  He was subsequently admitted to the Children's Hospital for one night.  There is an assumption of RSV, though he was never formally tested.

Yesterday, I took Josiah to his scheduled appointment with the cardiologist.  The MD noted the rapid breathing and chest congestion, not surprising given the respiratory infection.  They performed an echo cardiogram.  The MD read the results, came in, asked me a few questions.......then the three pieces of news.

1. The original hole (VSD) in Josiah's heart never fully closed.  They are able to see how large it was, the portion that his own tissue covered, and the hole that still remains.  I am told this is mild-moderate in size.

2.  Josiah also has an atrial septal defect (ASD).  I am told this is mild-moderate in size.

3.  Most concerning, the right side of Josiah's heart is quite enlarged.  The right side of the heart is the side responsible for pumping air to the lungs.  It is hoped that his heart has been working harder due to the respiratory infection.  If that proves true, the heart should decrease in size once the infection clears up.

The positives: Josiah has not fever, is eating well, sleeping well, and not sweating during feeds.  His oxygenation level is good (avg 97/98) and blood pressure is good.

Teary-eyed, I went to the pediatrician immediately afterwards.  Josiah was given a nebulizer treatment in the office, which seemed to improve his airflow.  We were given a nebulizer to bring home.  We will use this three times per day for the next ten days.

We have a follow up early next week with the pediatrician.

We have a follow up appointment scheduled at the Children's Hospital in two weeks.  They will perform another echo cardiogram and compare the two.  We are keeping our fingers crossed that a marked improvement will be evident.

“Fear can keep us up all night long, but faith makes one fine pillow.” - author unknown

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