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What Do My Lab Test Reports Indicate?

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Posted on Thu, 3 Aug 2017
Question: Hi Doctor,

I am attaching the report of xxxxxx. He had a hole in in his heart and he under went a surgery 2-3 months back in XXXXXXX But after 2 months the doctors are again saying that there is another hole and he might have to undergo another surgery after few months. I need an opinion from you on the reports attached. I have attached 4 reports
1. Historical reports - test done when he was just 2 months old in 2007
2. Pre surgery details
3. Surgery details
4. Test done post 2 months of surgery
doctor
Answered by Dr. Rishu Saxena (1 hour later)
Brief Answer:
Go for surgery asap otherwise in few years reversal of shunt will happen.

Detailed Answer:
Hi ,
Thanks for choosing HealthcareMagic for your query.
As per the reports yes there is a large VSD and requires surgical closure.Long term untreated VSD leads to Eisenmenger syndrome.It is a condition that includes a collection of symptoms: cyanosis (pale blue or grayish skin due to decreased oxygen in the blood), pulmonary hypertension (high pressure in the blood vessels of the lungs), and erythrocytosis (increased number of red blood cells due to decreased oxygen in the blood).Usually in a hole blood flow from left to right but if hole remain unclosed for years the flow reverses causing number of problems.

Due to untreated VSD the blood flowing from left to right may cause right ventricular mass expansion hence causing reversal of shunt.A right-to-left shunt is a cardiac shunt which allows blood to flow from the right heart to the left heart.

This is very dangerous and can be life threatening.

Suggestion
surgical closure of vsd.



Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Rishu Saxena (17 minutes later)
Thanks Doctor.

However the kid underwent a surgery just few weeks back. Is it recommended to under go another surgery immediately or should we wait for some time to heel the things properly.

secondly, i am surprised how the another hole was not detected during the tests before the surgery and now after the surgery the doctors found another hole
doctor
Answered by Dr. Rishu Saxena (13 minutes later)
Brief Answer:
Reply.

Detailed Answer:
Hello dear,
Firstly i would like to answer your second question.
VSD is detected by echocardiography. The problem with this test is that result depends on the quality of machine,The experience of cardiologist or technician doing echo.I have never heard of these two names (rumak jaydav) so i don't know the expertise of the person performing echo(aloha he missed a large defect).

Don't take it otherwise but charges of open heart surgery as mentioned in discharge is just 70k which is just 40% of any good corporate hospital.So you can very well understand that easiest way to cut down cost is having chinese machines undertrained technicians and young doctors.
For your information I-33 3d by philips costs 3 crore while echo machine by chinese manufacturer costs about 30 lakhs.Missing such a big defect raises questions but alas i XXXXXXX you can't question any one.

This is nothing but HUMAN error.

It's better not to rush for immediate surgery.Consult a pedeiatric cardiologist in person at a hospital like XXXXXXX XXXXXXX XXXXXXX or Medanta the medicity. Get a echo repeated at a good center and then chalk out a plan.


Thanks.

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Kampana
doctor
Answered by
Dr.
Dr. Rishu Saxena

Cardiologist

Practicing since :2012

Answered : 696 Questions

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What Do My Lab Test Reports Indicate?

Brief Answer: Go for surgery asap otherwise in few years reversal of shunt will happen. Detailed Answer: Hi , Thanks for choosing HealthcareMagic for your query. As per the reports yes there is a large VSD and requires surgical closure.Long term untreated VSD leads to Eisenmenger syndrome.It is a condition that includes a collection of symptoms: cyanosis (pale blue or grayish skin due to decreased oxygen in the blood), pulmonary hypertension (high pressure in the blood vessels of the lungs), and erythrocytosis (increased number of red blood cells due to decreased oxygen in the blood).Usually in a hole blood flow from left to right but if hole remain unclosed for years the flow reverses causing number of problems. Due to untreated VSD the blood flowing from left to right may cause right ventricular mass expansion hence causing reversal of shunt.A right-to-left shunt is a cardiac shunt which allows blood to flow from the right heart to the left heart. This is very dangerous and can be life threatening. Suggestion surgical closure of vsd.