Dr Hive, Chief of Pediatric Cardiology, can you name this murmur

[wapiti]

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[endurancerider]

Aortic Insuffiency?

Aortic Stinosis?

Sounds like he could have problems with his heart getting perfusion, probably going to check for cardiomegaly with the echo and perfusion.

 

Is there any history of asthma or breathing abnormalities or lung abnormalities?

[CalicoKat]

while we wait for the appointment with the real pediatric cardiologist (and presumably an echo) next week. Whoever wins gets.... nothing but satisfaction in your ability to play a doctor on the internet ;)

 

new murmur (detected at well checkup by ped)

mid-systolic

high-pitched

at apex

intensity level 2

 

8 y.o. ds, recent decrease in height percentile enough to call for a re-measure in a few months, history of other weird random medical issues, e.g., kidney obstruction (surgically repaired), tethered spinal cord (surgically repaired), thrombocytopenia, genetic thrombophilia, small-for-gestational-age 33-wk premie (was septic; respiratory distress), history of developmental delay, sensory issues, speech delay.

 

I've been googling to little avail. Different sites describe things differently, and I haven't seen anything with this particular combination.

 

Ped doubts it is an innocent murmur (dd has one, I know about them). It could still be something minor. I've been to enough specialists that I know I do better having more info about the various possibilities going in. It's much easier to ask questions that way (you know, knowledge-is-power). I promise I won't freak myself out. really! :D

aortic stenosis? or aortic stenosis of a bicuspid valve?

[wapiti]

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[Teachin'Mine]

I have no idea, but I'm praying for you and your son. :grouphug:

[wapiti]

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[kalanamak]

Apical midsystolic murmurs in children, without associated gallops or clicks, or obvious things like cyanosis and clubbing, and without radiations can still be innocent. They aren't the "classic" buzzy innocent murmurs at the left sternal border, but they can still be "innocent". Especially if they aren't greater than 3/6.

 

But echos are painless and safe. I'm sure my son would get a thrill out of it, but he hasn't learned to associate doctors with surgery etc. :grouphug:

 

(I know little peds cardiology, but I remember memorizing the innocent murmurs as less complicated, and useful is sorting the "uh oh" from the "ah so" murmurs in kids, just in case I met with one.)

[wapiti]

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[kalanamak]

Can a murmur just spring up from out of nowhere?

 

Well, I hear new ones in PG ladies, and in people who develop hyperthyroidism. Has to do with increased cardiac output. (Remember, I don't know peds, but, kids are changing. E.g. the classic innocent murmur is around K age. Not at birth, not at 10.... okay, that one I looked up. :))

 

Hope you get a friendly tech who will be charmed by your son's interest. Look at some YouTubes first, to get an idea about what he's looking at.

[wapiti]

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[Sugarfoot]

I have a grade 3 functional murmur that developed at age 13. Apparently, it's pretty loud, and I try to warn new doctors before they hear it so nobody panics.;) I'm not sure what type it is, exactly. I'd ask my DH, but he's sleeping (noisily:glare:)

[wapiti]

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[Perry]

 

new murmur (detected at well checkup by ped)

mid-systolic

high-pitched

at apex

intensity level 2

 

 

 

A high pitched systolic murmur heard at the apex is usually associated with mitral regurgitation. But it's typically holosystolic rather than mid-systolic.

 

Ventricular septal defect murmurs can be high pitched, but isn't heard best at the apex. Kids with VSD often have lots of respiratory infections.

 

Aortic stenosis is mid-systolic, but it isn't heard best at the apex and it isn't usually high pitched.

 

Aortic insufficiency is a diastolic murmur, not systolic.

 

Hopefully it's an innocent murmur and nothing to worry about. If it isn't innocent, I think the most likely cause would be MR or VSD.

:grouphug:

[wapiti]

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[Amy in KS]

:grouphug: and praying...

 

If it makes you feel any better, my daughter was sent for an echo for a very non-innocent sounding heart murmur. It turned out to be innocent (albeit , an atypical innocent murmur). I'll be praying the same happens for you!

Edited June 17, 2011 by amy in ks

[wapiti]

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[Perry]

The good news is that the VSD is so tiny he will never need to get it fixed.

That's great news! So glad he's okay. :)

[Teachin'Mine]

Good news! :)

[wapiti]

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[wapiti]

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[H_Household]

Praying for your family. Our second son was born with a heart murmur...so we were sent at day 2 of his life to the cardiologist. He was two holes in his heart but thankfully not big enough to cause issues. We were blessed 6 months later to get the news that God had healed his heart completely. Praying the doctors to have understanding how to help and peace for you as you wait for more answers.

[Slartibartfast]

:glare: slight wrinkle - doc called today to say that the specialists have decided that the thickening of the septum will require more tests, to rule out hypertrophic cardiomyopathy (HCM). I must have misunderstood him before, but ds is not yet diagnosed with HCM.

 

Apparently, if they do diagnose HCM, standard procedure is to echo all family members, including parents and siblings, because it is genetic. I've already had an echo (8 yrs ago), but no one else has. Assuming the cost of each echo and corresponding consultation is greater than our $800 deductible, which is just a guess, (5 kids + DH) x (deductible) = almost $5k :glare:. I'm grateful for modern medicine, of course, but irked because our family has a long history of wild goose chases and wacky medical issues that often turn out to not be serious. Keeping our fingers crossed that we dodge another bullet.

 

On with the tests on ds for HCM - a blood draw and the holter test. At least they're simple. They're fed-exing me the holter - never heard of such a thing :lol: (the mailing of the holter, not the holter itself - I've done the holter test before).

 

My son has a genetic condition where there is a chance of HCM. It is scary, my son's cardiologist did say she wanted all family with a history of murmurs to have echos. He was born with two VSDs, pulmonary artery stenosis and pulmonary valvular stenosis.

 

Have they tested for any genetic conditions? Have they mentioned any to you?

Edited September 8, 2011 by Sis

[wapiti]

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[sbgrace]

I'm glad things are calming down and seem to be working out. :grouphug:

 

How long ago did you visit genetics? There has been a lot of progress in that field just in the last few years. Your son has so many markers indicating something must tie them together. I'm thinking the technology could possibly be there now to figure out the what particularly if it is indeed genetic.

[wapiti]

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[HLDoll]

My son has aortic stenosis/bicuspid aortic valve. Ped heard the murmur when he was an infant and sent us to Ped Cardiology. They ran all the tests and told us it was innocent, don't worry about it, thanks for coming. Fast forward 3.5 years and a new Ped brings up the murmur. I explain we've already been cleared by cardiology, but he says he doesn't like it and wants us seen again. We went back to the same cardiologist practice for a retest. They pulled up his prior records and compared them and there was definitely a change. He will now see a cardiologist annually for the rest of his life, more often if he experiences a significant degree of change in any given year, as he did between 6 mos. and 4 yrs. This is just to say that something mild and barely detectable that may have been there years ago can change and become more serious. Obviously, my son's toddler growth spurts taxed his heart and led to a worsening of an innocent condition. My daughter is 6 and at her recent physical the Ped thought she heard a murmur, and it's the first time anyone has every said anything about her. Given that my son's condition tends to run in families, I'll be taking my daughter in for a cardiology visit soon. Our cardiologists are wonderful, and my son likes his annual visits. Nothing painful and the doctors are all very good with kids.