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How can ventricular septal defect with patent ductus arteriosus be treated?

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Posted on Tue, 11 Sep 2018
Question: What does this test mean? Does she have a VSD? How can ventricular septal defect with patent ductus arteriosus be treated?
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Answered by Dr. Sagar Makode (30 minutes later)
Brief Answer:
Yes, there is VSD and PDA.

Detailed Answer:
Hello,

Yes, they've mentioned trivial VSD and PDA, which means there is very small VSD and PDA.

Since they have mentioned it to trivial (size is not mentioned), its likely to be for medical management only. All other chambers and function are normal implying VSD and PDA are not hemodynamically significant.

Hope this helps you and get back if you have any doubts.

Regards,
Dr. Sagar Makode, Cardiologist
Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Sagar Makode (1 hour later)
So no VSD? That could have caused a stroke? No know heart abnormalities? Sorry just seen you said yes small VSD. Could that cause a stroke? And in one of her records only a few days later it says VSD resolved, is that possible? and what does that mean?
doctor
Answered by Dr. Sagar Makode (29 minutes later)
Brief Answer:
See the description below.

Detailed Answer:
Hi,

Yes, it's possible for small VSD and PDA to resolve on its own within few days. After resolution, stroke is unlikely.

When did the stroke happen, was it immediately after birth? As I can see, the report is of May 12 and also mentioned stroke VSD there, is there another stroke after that?

So it's possible to have a stoke in patients with VSD due to paradoxical embolism, but these patients also need other tests like MRI brain etc for other causes, which I guess must have been done.

Hope this answers your query. Let me know if you need further assistance.

Regard,
Hope this helps you and get back if you have any doubts.

Regards,
Dr. Sagar Makode, Cardiologist
Above answer was peer-reviewed by : Dr. Yogesh D
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Follow up: Dr. Sagar Makode (22 minutes later)
She had a stroke during labor and delivery. No stroke after that. She had MRIs done. I was told by a cardiologist in XXXXXXX it's impossible even with the smallest VSD for it to close that fast. Should a vacuum assisted delivery be used on a child who had a small heart murmur? My gynecologist said he heard a heart murmur when she was in my belly, but said later it cleared on it's own before delivery, so we thought no more about it till now. I did not know VSD and a murmur are related. I will send the two MRIs I have.
doctor
Answered by Dr. Sagar Makode (24 minutes later)
Brief Answer:
See the description below.

Detailed Answer:
Hi,

Ok, she had a perinatal stroke. In that period, babies normally have another channels in the heart called as foramen ovale which is more important than trivial VSD to cause a stroke. This close after birth. So this could have caused the paradoxical embolism.

Next, VSD will cause a murmer. Murmer is a clinical finding due to VSD. There could be other reasons for murmer as well, but yes it could correlate with VSD. The VSD mentioned is trivial so it means it's very very small ( between none and small VSD).

Its possible he had detected it on the verge of closure and go completely closed or flow stopped after few days. More importantly, it is closed. So likely reason is foramen ovale rather than VSD.

Also, I guess there is no such protocol or benefit to routinely use vacuum for delivery.

Hope I have answered your query.

Regards,
Dr. Sagar Makode, Cardiologist
Above answer was peer-reviewed by : Dr. Yogesh D
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Dr. Sagar Makode

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How can ventricular septal defect with patent ductus arteriosus be treated?

Brief Answer: Yes, there is VSD and PDA. Detailed Answer: Hello, Yes, they've mentioned trivial VSD and PDA, which means there is very small VSD and PDA. Since they have mentioned it to trivial (size is not mentioned), its likely to be for medical management only. All other chambers and function are normal implying VSD and PDA are not hemodynamically significant. Hope this helps you and get back if you have any doubts. Regards, Dr. Sagar Makode, Cardiologist