Thursday, September 5, 2013


so i thought i would write about our cardiologist appointment yesterday mainly because this helps me remember everything and also, there is so little on the web about situs inversus with levocardia (flipped organs except the heart is on the left) maybe some of this will help someone else.

so i've learned not to assume that medical people know what situs inversus means.  you would think if they are looking at the order from the pediatrician to perform an ekg and echocardiogram due to situs inversus and you didn't know what that term meant, you would look it up.  yea, don't assume that.  i've learned my lesson and will verbalize that from now on at every appointment.

so, first the nurse did an ekg on little man.  he did not like this part because she put a million little sticky things all over him and then had to rip them off when she was done.  she also took his blood pressure, temperature, weight and length.  because he was getting fussy and hungry, i fed him before they did the echocardiogram.  the tech doing this was clearly in the wrong profession or having a really bad day and i had to pray myself through her attitude towards my squirmy baby.  i mean, he is just 12 days old, what do you expect, for him to be perfectly still the entire time???  this took about 45 minutes then we were back in the patient room waiting for the cardiologist to take a look at those pictures.

i loved the cardiologist.  he was an older gentleman and very sweet and thorough.  he brought the above picture in to explain exactly what he saw on the echocardiogram.  i am a visual learner so this helped me SO much!

so the diagnosis was what i expected from the research i've been able to do online.  the main issue has to do with the inferior vena cava.  they call it an "interruption of the vena cava."  if you look at the bottom left of the picture, you can see where this vein enters the right atrium from the lower parts of the body.  this did not form in silas so instead that blood comes up through a vein that runs behind the liver (which is on his left because things are flipped) and behind the heart and enters the right atrium at the top instead of the bottom (azygous vein to the superior vena cava).  so the blood gets to where it is meant to go, just in a different way.

he also has a ventricular septal defect (VSD) that is about 2mm.  this is the circle noted in the middle of the picture.  lots of babies have this and because the heart still has a lot of growing to do, it usually closes on its own.  he could not hear it with his stethoscope and he said even if it doesn't close, which it may not, it is so small that it will not cause any problems.

he has a similar hole between the right and left atriums (patent foramen ovale) that will also likely close as his heart grows bigger.  again, this is something that should not cause any problems.

so we talked about the rarity of situs inversus and how he has only had one other patient similar to silas.  it is likely a genetic thing but there is still a lot they don't know about what causes it.  he said if we were to have more children our odds of seeing this again in another child are about 2% more than anyone else.  also, silas' kids may be more predisposed to having this as well but the odds for that are just about 5% more.  it is such a mystery to me how all of this happens and really makes me appreciate the extreme intricacies that the Lord has established in the human body.

so his long term heart prognosis is great.  the cardiologist recommended that we come back in 6 months for a follow up to check on the status of the defects and to see if they have closed.  we are SO thankful for a good heart report!

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