Thursday, May 29, 2008

Matters of the heart

Hey y'all,

Just wanted to update you on Emma's heart situation. We went to her appointment yesterday.

If you remember, Emma complained of chest pain April 22nd, and we tool her to the ER. They ordered an chest xray and said they thought it was muscular pain or growing pains, but wanted us to see a pediatrician just in case (we normally just see a family doc). The pediatrician we saw a week later said that- after me telling her that Emma had been known to have a murmur on occasion, only to have it gone on other visits- that she did hear a murmur but didn't think it was anything to lose sleep over. She listened to Em's heart for a very long time, but she said she would like to have it checked out by a pediatric cardiologist just to be sure, and so that we would have a baseline diagnosis/evidence of normalcy for the future things like other doctor visits and checkups, plus sports in the future. I also told her (just as I had the ER doc) that Emma had periods where her lips wold be a little dusky/blue, as well as her nail beds. I would have her move around a bit and she would "pink up" after a few short minutes, always without complaints about the whole thing. Emma was always asymptomatic. The doctor said that this was actually fairly normal for kids Emma's age and to not worry about it.

Surprisingly, no EKGs were done either visit, but the pediatrician said that she would rather have the specialist do it.

So... yesterday, Em had an EKG at the ped. cardiologists office, which was normal. The doc then came in to see her and said that she did hear a murmur and the spot she heard it in seemed to be one of the lower chambers. Her thoughts were that it was most likely a small hole in one of the lower chambers (called a ventricle). She thought that the blue lips/nail beds was normal for her age, that the murmur was slight leading her to believe that the hole was very small because her EKG was normal... but she wanted to do an ultrasound of the heart to check out the size of the hole.

The BAD news:
She checked the heart valves and came across a birth defect that turns out to be pretty common.Normally the aortic valve, when closed usually looks like a Mercedes sign and it has 3 flaps that open and close when the heart pumps blood from from the lower chambers. This is called a tricuspid.

Emma's aortic valve is what is called a Bicuspid because 2 of the flaps are stuck together, and because they are stuck, her valve looks more like a foot ball shape when the flaps are open, instead of a perfect round shape that a tricuspid has when open. She also noted that the valve flaps are a bit thicker than they should be.

The GOOD news is that she couldn't find the hole in the lower chambers of the heart, she she believes it is a pin sized hole. Also, even though she has this heart defect, she said the heart is beating normally, not working too hard to compensate. Also she said there was no regurgitation of blood back into the lower chamber of the heart, meaning , as she put it " the heart isn't back washing blood back into the lower section". VERY good news. Also, the valve is closing completely right now. She believes that Emma will have a normal childhood, the heart is beating perfectly. The problem will be if and when her body grows but the aortic valve doesn't, therefore causing the Bicuspid (two flapped) valve to remain partially open, causing back flow of blood and making the heart work twice as hard. If this happens - most likely near or into adulthood- she will need surgery to fix it.

There are no restrictions to her activity, thank goodness. She is allowed to run and play like any normal kid. ;)

She wants to see Emma back in 2 years for a full work up, and wants both of the kids to have their cholesterol checked since Johns side (maternal and paternal) all pretty much have high cholesterol.

Through all of this Emma was very watchful yet grouchy, but she didn't cry once. She did complain when the doc was doing the ultrasound of her heart. A few times she cracked us up by saying "OW!" when the doc wasn't even touching her. I said that she was probably complaining because she's pretty bony, Emma is a peanut. The doc was trying to distract Emma by asking her questions and encouraging her to look at the screen, but Emma- in TRUE 'vich fashion (John's side of the family)- ignored her out of sheer stubbornness, which we also thought was hilarious. She would only answer the questions if I re-asked them, refusing eye contact while watching Nemo.

Anywho, we are praying that God keeps her heart working normal, the hole heals up... I might even get the courage up to ask for complete healing... Because we have had evidence recently that God is an awesome God, and he hears our prayers, haven't we (my cousin Rachel)? *big grin*

Thanks for listening, and your prayers too.



~Virginia~ said...

aw, poor kid's been through a lot, but i'm glad things seem to have gone well. :)

Adam said...

Hey Mary,

FYI, I was born with a bicuspid valve and lived 33 years before I need any form of surgery.

I ended up having severe aortic stenosis that required double valve replacement surgery.

The recovery was very tough.

Emma sounds like she is in the clear. Wooo-Whoo!



Pamela said...

amazing what technology will find. Think about all those kids 150 years ago who didn't have such wonderful physicians. I'm always amazed.
Blessings on that little bony kid!!!

I had much chest pain as a kid - but I believe it was acid reflux. As now I have it again.

Jenny Ryan said...

Thanks so much for the update. So glad she's okay!

Holly Schwendiman said...

Awww so glad for the update. My 2.5 year old niece had surgery last week for some lung issues that also turned out to be birth defect in origin. They are so resilient! Keep us posted.


Jean Marie said...

my bf's had his heart surgery just last year october. he has hear murmur as well. the doctor said its congenital and had that since he was a kid. he' 39 now and imagine, just had his surgery last year. and now, he's super great. good as new. i know everything will turn out well with ur daughter.