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It’s been a while since I last update on Anaqi’s cardiac condition. Back in May 2009 – weeks into his presence into this world – news of him having two holes in his heart daunted upon me. When cardiologists mentioned of the probability of a heart surgery, I was distraught. In fact, the whole family was. I prayed hard that it’ll never happen and that the holes will eventually get smaller and close on their own.

In case you haven’t heard, this was the entry I posted last year on my blog: http://aprima.org/2009/05/28/echocardiogram

Back then, his echocardiogram report was as follow:

Early in this year, on 6th Jan, I had brought Anaqi for a follow up check-up at KKH. His cardiologists said they could still hear slight murmurs in his heart when they listened via their stethoscopes. To confirm, they did another echocardiogram to scan his heart.

He slept soundly during the whole diagnosis, which took about an hour or so to complete. It seemed as though it had gone on for hours.

Last year when Anaqi did his first scan, I wasn’t focusing on the screens and was oblivious to the beeps and readings (that was before the doctors broke the news about the holes in his heart). The images on the screen looked similar to what I’ve seen during my FA scan when Anaqi was inside me.  This time I paid attention to every single detail. His sleeping helped me focus better.

The result made me beamed a hundred dollar smile. Alhamdulillah, I was informed that one of his holes (the ventricular septal defect – VSD) has spontaneously closed! Which was surprising because the VSD was much bigger than his ASD (atrial septal defect). His ASD is still there however it has reduced in size to about 2.9mm. This is indeed great news! He no longer need to consume his medication – diuretics -  for flushing out fluid from his lungs due to the mix of oxygenated and non-oxygenated blood flowing into them. His next follow up check-up will be in December this year. I hope then it will bear even better news for us, insyallah.

His scan results on 6th Jan.

An appointment was set up on 25th May for Anaqi to undergo an echocardiogram at the Cardiac Centre at KKH. After a detailed analysis, it turns out that his PD’s suspicion indeed holds true. Anaqi is diagnosed to have "moderate to large perimembranous ventricular septal defect with inlet extension (VSD), moderate atrial septal defect (ASD), high pulmonary pressure". In short, he has two holes in his heart – one in the upper chambers (atrium) and one (slighter bigger) in the lower chambers (ventricle).

Here’s a detailed graphical representation of ASD, VSD versus the normal heart.

According to KKH website library, the left atrium and ventricle is normally at a highler pressure than the right, so the defects allow blood to flow from the left to the right. Blood is shunted across and re-circulated back to the lungs. The effects of having "extra" blood flowing across into the right atrium/ventricle are:

• ASD – The right-sided upper heart chamber (right atrium) and right-sided lower heart chamber (right ventricle) become dilated to accommodate this extra blood volume.
• VSD – The left-sided upper heart chamber (left atrium) and left-sided lower heart chamber (left ventricle) can become dilated to accommodate the extra blood volume returning from the lungs.
• The lungs becomes more "wet" or even become "flooded" with this extra re-circulated blood.
• The blood pressure in the lungs increases.

The degree at which these effects occur would depend on the size of the ASD/VSD and the amount of blood that is re-circulated back to the lungs. This can range from insignificant to severe.

Here’s a graphical representation of blood flow of a heart with ASD/VSD (courtesy of KKH):

According to the cardiologist who did his scan, this is treatable – so this is good news! Anaqi will need to undergo periodic review to see if, over time, the holes will eventually get smaller, or if otherwise, he may need some medication to "buy time" before he’s ready to undergo surgery.

Let’s all hope for the best for the little one.