My baby is having shortness of breath while I am breastfeeding. What could be the problem?

Question

Hi doctor,

I am presented with a three-month-old male baby exhibiting shortness of breath, becoming tired while breastfeeding, and not gaining weight well. Skin becomes slightly cyanotic when he is distressed and crying. Physical exam findings reveal temperature- 98.9 degrees Fahrenheit rectally, eyes, ears, nose, and throat are within normal limits, lungs auscultate within normal limits, respiratory rate is slightly elevated above normal, heart rate of 110 bpm, holosystolic murmur noted upon auscultation. The digestive system is normal other than those noted in the signalment. Skeletomuscular, nervous, urinary, and reproductive systems are all within normal limits. Lab results show glucose level- 120 mg/dL, reticulocytes- 1.8 percent, hematocrit- 54 percent. What is the diagnosis for this, and what would be the prognosis for this baby?

Answer 1

Hi,

Welcome to icliniq.com.

Thanks for the query. Echocardiography shows a large-sized VSD (ventricular septal defect) with a left to right shunt, probably because the picture is black and white and color Doppler findings are not adequately visible (attachments removed to protect the patient's identity). Please send me a full echocardiography report to see the exact size and location of the defect, shunt fraction, dimensions of ventricles, pulmonary artery pressure, and any associated cardiac anomalies. Treatment options are device closure and surgical but depend upon the exact anatomy for which a pediatric cardiologist should preferably do detailed echocardiography. Prognosis is usually very good for small restrictive VSDs, which spontaneously close over the years. For large VSDs, prognosis depends upon LV (left ventricle) and RV (right ventricle) function and pulmonary artery pressure. If pulmonary pressure is normal or slightly elevated, the prognosis is usually good after an intervention. Thank you.