newborn baby

[mandy60]

my 2 day old has just been admitted to hospital.  He had been twitching in his sleep, test show he has low sodium levels and they can detect a heart murmur.  They were going to let him home but then thought that his heart appears round and he needs to see a heart specialist. what could this be and could this be very serious

[Jeffrey R Boris, M.D.]

Dear Mandy,

I am sorry that your son was admitted to the hospital so early in his life.  Unfortunately, I have very little information to try to help you with this, as this may be totally normal or it may be a serious problem.  Allow me to explain.  A murmur, or extra sound in the heart created by turbulence, can be normal or abnormal.  Normal, or innocent, murmurs can be heard in up to 77% of all newborn infants.  However, approximately 1% of all babies born has something structurally wrong with the heart, otherwise known as a congenital heart defect.  Furthermore, I am guessing that when you say that they think that his heart appears “round”, they are making this finding on interpretation of a chest radiograph, or chest X-ray.  Unfortunately, these are not the most exact tools for diagnosis.  Radiographs should be filmed when the patient has taken in a full inspiration; however, it’s hard to get a baby to hold his breath.  If the radiograph demonstrates an incomplete inspiration, it can make the heart size look large or rounded.  In your son’s case, I don’t know if the film was adequate, or not.  I hope that these findings are incidental findings and are not serious at all.  However, if further testing is indicated and a congenital heart defect is found, make sure that you are comfortable with the information that you are getting and ask questions so that you understand the process going on with your son.

[mandy60]

Thankyou very much for your reply.  At present my son has had numerous tests.  They believe he is intolerable to cows milk.  He has been given new milk which he is responding too it well and sodium levels are rising.  He has a heart murmur however they have no concerns regarding this.  They will keep him in for a further week to run tests but so far every test has come back positive.  thank you again for your reply.