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Normal murmurs are usually diagnosed by the typical sound heard with a stethoscope during a physical examination. Some murmurs require additional tests, such as an electrocardiogram ECG or echocardiogram Echo to distinguish them from much less common abnormal murmurs. Heart abnormalities can on rare occasions run in the family. However, if you do not have congenital heart disease and your sister is the only family member to be born with a heart problem, then your daughter is not at increased risk of having such a problem.

Sometimes, when a doctor first hears the murmur through a stethoscope, he or she may want to have other tests done to be sure the murmur is innocent. After that, there's no need for a cardiac reevaluation unless the patient or doctor has more questions.


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The child doesn't need medication, won't have cardiac symptoms, and doesn't have a heart problem or heart disease. A parent doesn't need to pamper the child or restrict his or her diet or activities. The child can be as active as any other normal, healthy child. When my son is sleeping, his heart rate frequently varies at 80, 60 and 40 with a few seconds pause; no color change is noted.

Is this an indication of any potentially serious problems? If so, a heart rate of 80 beats per minute would be within the realm of normal. The heart rate will go down during sleep and it will vary from time to time, most often with his breathing pattern. My sister was told her daughter needs a heart transplant. Can you provide me with information about this?


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Heart transplantation involves replacing a failing heart with a new one donor heart. Children undergo heart transplantation for two primary reasons -- a congenital heart defect or severe malfunction of the heart muscle. Heart transplantation is considered when there are no other medical or surgical options. The hearts are donated from someone who has suffered an injury resulting in death of his or her brain, but not the other vital organs and whose family has agreed to make the heart and other organs available for donation.

Many children who receive heart transplants live years longer than they otherwise would have and have an excellent quality of life. The waiting time for a heart can range from days to months even more than a year and depends on multiple factors including size, blood type, and whether the patient is hospitalized on intravenous heart medications. Patients who receive a heart transplant need to be on medications to prevent their own body from attacking the heart rejection. Unfortunately, these medicines have many side effects, including making the body more susceptible to a dangerous infections, damaging the kidneys, and even cancer.

Frequent visits at least every three months to the transplant cardiology team are required for close monitoring. My 8-year-old daughter was just diagnosed with ventricular hypertrophy. When she was 2, she was diagnosed with a heart murmur and I was told that she would probably outgrow it. Can you shed any light on how this could have happened? The murmur your child had at age 2 likely had nothing to do with her current diagnosis. Murmurs, or "extra heart sounds," are very common in children and are usually "benign" or "innocent" murmurs.

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These extra sounds may arise from the thin chest wall and rapid growth seen in early childhood. You have been told that your daughter has "ventricular hypertrophy," which is a thickening of the heart muscle. This diagnosis can be suspected by an electrocardiogram, but needs to be confirmed by an echocardiogram read by a pediatric cardiologist. Ventricular hypertrophy can occur from stenotic blocked heart valves, high blood pressure, or can be the result of a condition called hypertrophic cardiomyopathy. Hypertrophic cardiomyopathy is caused by several genetic defects resulting in an abnormally thick heart muscle.

This disease can run in families or be the result of a new genetic mutation. It can result in poor heart function, heart failure, heart rhythm problems and in some severe cases, can cause passing out or cardiovascular collapse. If ventricular hypertrophy is confirmed by further testing, it is important that the cause be determined and the appropriate treatment and medical checkups be followed. My son was born with Hypoplastic Left Heart Syndrome. He has had two operations and we have been told that he will need another one.

Although his doctor has explained what he has to me, I still don't understand what is wrong with him and why he is blue and can't keep up with other children his age. Will he always be like this? The right ventricle normally pumps blood to the lungs, while the left ventricle normally does all the work to pump the blood to the rest of the body. In your son's case, the primary problem is that the left ventricle did not develop properly during the pregnancy and the right ventricle has to do all the work.

The first two operations result in the oxygen poor blood from the upper half of the body going directly to the lungs and the rest of the blood mixing together and going to the body. The oxygen poor blood returning from the body mixes with the oxygen rich blood. The mixed blood is then pumped to supply the body, causing him to appear blue. This may allow him to better keep up when participating in physical activities. Her cardiologist said it would not need to be repaired. Recently, I was talking with some parents in a local support group.

They said kids with congenital heart defects need to take antibiotics before going to the dentist to keep them from getting endocarditis. I called her doctor, and she said that our daughter did not need antibiotics.

Should I tell her dentist that she needs antibiotics? What are the antibiotics for? What is endocarditis? Most children with congenital heart defects are at an increased risk for developing bacterial endocarditis , an infection of the lining of the inside of the heart or the heart valves this lining is called the endocardium. Bacterial endocarditis also called infective endocarditis occurs when bacteria in the bloodstream bacteremia lodge on abnormal heart valves or most structural abnormalities of the heart. Certain bacteria normally live on parts of the body, such as the mouth and upper respiratory system, the intestinal and urinary tracts, and the skin.

Some surgical and dental procedures cause a brief bacteremia. Although bacteremia is common following many invasive procedures, only certain bacteria commonly cause endocarditis. For many years the American Heart Association recommended that children and adults at increased risk for endocarditis take antibiotics before certain dental and surgical procedures. This was done because it was thought that when someone was having one of the dental or surgical procedures that can cause bacteremia, antibiotics could be given to prevent the bacteria from surviving in the bloodstream.

However, the AHA made major changes to their guidelines in After they reviewed all of the scientific evidence on the causes and prevention of endocarditis, they concluded that the prophylactic dose of antibiotics given before dental and surgical procedures prevent very few, if any, cases of endocarditis. There is also some risk involved with taking antibiotics.

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Therefore, the new guidelines say that antibiotic prophylaxis should be reserved only for those children and adults who have the greatest risk for a bad outcome if they get endocarditis. Patients with congenital heart disease who are at the greatest danger of bad outcomes from IE and for whom preventive antibiotics prior to a dental procedure are worth the risks include those with:. Except for the conditions listed above, antibiotic prophylaxis is no longer recommended for any other form of congenital heart disease. Other people who are still recommended to take antibiotics before most dental procedures include those who have a prosthetic heart valve, those who have previously had a case of endocarditis, and a cardiac transplant patient whose heart develops a problem in a heart valve.

Most of these situations would be in adults, but some could be children. Furthermore, the AHA emphasizes that for anyone at increased risk for endocarditis, good oral health and hygiene by regular tooth brushing, etc. My daughter was born with an interrupted aortic arch and a double outlet right ventricle.

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Please explain these heart defects to me. What are my chances of having another child with the same condition? Your daughter was born with several complicated heart defects that involve problems with the heart pump as well as both main blood vessels that supply the body and lungs. In this condition, the main blood vessel to the body aorta is interrupted in the area of the blood vessels that supply the upper body.

In addition, instead of the lung artery pulmonary artery and aorta coming out of separate chambers, both arise from the right-sided ventricle. There is also an associated hole ventricular septal defect or VSD between the pumping chambers.

Hemolytic Disease of the Newborn Treatment & Management

This heart defect requires surgery during infancy. After surgery, your child will need to be seen by a congenital heart disease specialist for the rest of her life. This combination of heart defects may be associated with a genetic syndrome called "DiGeorge Syndrome," which may also include other defects such as abnormal function of the immune system as well as the gland that controls calcium in the bloodstream. This syndrome is caused by a genetic defect on one of the chromosomes, chromosome 22q The heart defects may also occur separately and can also be associated with a similar defect on the same gene.

This gene defect can be detected by a specialized genetic test FISH or fluorescent in situ hybridization. This test can determine if one of the parents also has this genetic defect or if this is a new defect gene mutation. The results of this testing will help determine the risk of having another child with the same or a related heart defect.