This child has severe obstruction to the blood flow from the left side of the heart to the body. A 10 mm aortic valve annulus in a 2 year old is about the size of the aortic valve in a newborn baby. It sounds like the thickening of the heart muscle (LVH) is due to this blockage, and the mitral valve leakage is due to either high pressure in the pumping chamber and/or an abnormal mitral valve. Propranolol may help suppress extra heart beats but will not help the underlying situation. This child needs surgery to relieve the outflow tract obstruction, which will likely need to be a very complex surgery called a Ross-Konno procedure. In this surgery, the outflow tract of the left ventricle is opened and the small aortic valve is replaced by the patient's pulmonary valve; also a conduit is placed from the right ventricle to the lung arteries. If this is successful in relieving the outflow tract obstruction, then gradually the thickening of the pumping chamber would regress. Without therapy of some type, heart failure will develop in this child, which will shorten the life span. If the heart fails, then a heart transplant might be indicated. Depending upon your location and access to medical care, these options may or may not be readily available to this child.
Sorry, there was an additional comment i left out accidentally, it says "Aortic annulus measures 10mm" ; is this very abnormal or why was it even mentioned?
He hasn't had any intervention. He just takes propranolol 8mg q 6hrs. Aortic arch is normal.
Has this child ever had any intervention? what about the aortic arch? there is no mention of whether there is a coarctation.