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Child has ASD closure, chest protruding again. Travelled by flight. What could be the problem?

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Cardiologist
Practicing since : 1981
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My nephew 4yrs old just had an ASD closure through open heart surgery 2 weeks back now his chest is protruding out again more than what it was before closure. Noticed it 3 days ago. He traveled by flight after 14 post surgery. What could be the problem
Posted Sat, 22 Sep 2012 in Child Health
 
 
Answered by Dr. Anil Grover 4 hours later
Hi XXXXXXX
Thanks for writing in.
I am a qualified and certified cardiologist. I read your mail with diligence.
ASD surgery is curative surgery as far as hole in the atrial septum is concerned. With arrhythmia the case is slightly different.

Explanation is simple ASDs are associated with supra ventricular arrhythmia ( Upper chamber beating out of rhythm) at times at faster rates. These are not cured by surgery. Person may outgrow it. These are minor arrhythmias with no danger to life. If you feel these are more than what he used have before surgery or generally discomforting take an appointment with pediatric cardiologist depending on weight he will prescribe a medicine either for regular or to be taken when symptoms occur (SOS). If you have any more question from me, I will be most happy to answer. If you ask followup question please upload one normal post op EKG and if you one with fast heart rate. Thanks.

With Best Wishes.
Dr Anil Grover,
Medical Specialist & Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW
Above answer was peer-reviewed by
 
Follow-up: Child has ASD closure, chest protruding again. Travelled by flight. What could be the problem? 41 hours later
His chest protrusion does not seem to be related to the heart beat, as it is on the bone called the sternum, so I am unable to understand how the answer provided relates to it. An ecg and echocardiography was done on 1st September 2012 and they are normal, the closure done is intact.
 
 
Answered by Dr. Anil Grover 24 minutes later
Hi XXXXXXX
Till last decade before 2000, all children who were to be operated and they were fortunate were to operated, surgery was done just before school going age. So I am answering this question based on personal observations of these children over the decades. Majority of of them were left with slight bulge of sternum bone with ribs cartilages included. Because exactly behind this is the right lower chamber of heart that is right ventricle. In ASD it receives 2-10 times (16 times I have seen in one girl) the blood flow more than other lower chamber that is left ventricle, hence the protrusion. As with closure of heart defect the blood blow in right ventricle is normal. Child is growing with no pressure behind sternal area. so as the time passes chest bulge or protrusion will become less and less prominent. It will not be there few years later at the most. Nothing to worry about. I am sorry I did not exactly knew what was the question. My apologies. Good Luck.
If you need any further clarification I will be only too happy to answer asap.
With Best Wishes.
Dr Anil Grover,
Medical Specialist & Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW

Above answer was peer-reviewed by
 
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