Brief Answer: No worries, cardiologist/cardiac surgeon opinion Detailed Answer: Hi and thanks for the query, I understand how exactly you can feel, especially at your age. The good thing is the ASD and mild pulmonary stenosis are all mild in your case, and you are not experiencing any symptoms at rest. It is therefore no major call for concern or worry that your doctor pays no serious attention to the murmur. I think this is so because he feels you really support the current clinical state. At this point in time, I do think you should be very much interested in considering very intense physical activity demanding activities. This is so because, your heart at this point is already developing compensatory mechanisms to cope with the side effects you have already. An intense physical activity, especially in continuum, considering the state of your heart could easily cause a failure in the ability of the heart to easily adapt and meet up with these demands. You shall be more likely to develop catastrophic heart events than someone without any heart malformation in the long run. The interest in preserving your heart function is not for the present, but for the future, due to increased probability of failure of heart compensatory/coping mechanisms in the future. The opinion of a cardiac surgeon could be sought. Surgery at times is an option to improve such symptoms and improve quality of life. This however requires expertize and experience, for in mild heart malformations like yours, complications could arise from surgery, even more serious than the heart condition itself. I think I buy the opinion of as a doctor of not worrying much about intense physical activity. A review by a cardiologist and cardiac surgeon however could be an interesting idea, to see if a surgical option could be considered. Kind regards. DR Bain

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Brief Answer: Cardiac ultrasound and clinical review Detailed Answer: Hi and thanks for the query, Brain confusion, brain fatigue and problems with language or concentration might require a neurological review. Fatigue could be explained by the heart condition you have. The heart malformation, especially when it gets serious could be accompanied by decreased blood supply to the brain which might partly explain the brain fatigue and general fatigue. It is imperative under these circumstances to exclude any form of onset of heart failure, which in some cases, could present itself as such. A clinical review and a cardiac ultrasound could be most helpful. I would just wish to inquire if you have taken any recommended vaccines like those for Hemophilus influenzae and Pneumococci, which are generally recommended, especially in persons with heart malformation, to avoid any risk of infection. My suggestion is seeing your cardiologist/cardiac surgeon once more for a proper clinical review and a heart ultrasound to ascertain the current heart state and function. Kind regards. DR Bain

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