3mm vsd left ventrical

[vickimetcalfe]

my daughter was diagnosed with a 3mm vsd when she was born (she was born on due date). she has had scans from birth to 2 years. the hole was still there at 2 years. i have since had problems with my new dr's getting her another scan she was due one at 4 years and it never happened. she is now 6 and i am going to take her private. the doctor says the murmur is still there. she still turns blue if she gets cold and it is hard to control her body temp most of the time. if the hole hasnt closed when she goes for her scan what are the next steps? my last consultant said she might need an operation if it hasnt gotten smaller what are the chances of this?
thanks
vicki

[Jeffrey R Boris, M.D.]

Dear Vicki

As mentioned above, a 3 mm ventricular septal defect is small and what we call hemodynamically restrictive.  This means that it does not cause any specific problems for the heart (unless it is a perimembranous defect, which can cause problems with the aortic valve).  Therefore, we don't do anything for a defect of this size.  Her other problems are likely unrelated to her heart, although without evaluating her, I cannot say for sure.  I would make sure that, at minimum, she is adequately hydrated, as many children and adolescent patients do not drink adequate fluid, and can then have worsening problems with autonomic nervous system control of the blood vessels, etc.

[potpourri0710]

A 3 mm VSD in a 6 year old would be very small, and is NOT causing the problems with blueness and body temperature/circulation issues. Some children have issues with this - my daughter is one. Her pediatrician just called it a primary vascular phenomenon (she mottles VERY easily, even on warm days and has Raynaud's Syndrome, and even on warm days her hands and feet can feel very cold, she's only 2). We were told that this "flukey circulation" can sometimes persist into teenagers.
That said, you might want to have her checked for thyroid problems, as they can cause problems with temperature regulation.