My 4 yr old will be getting a 3rd set or ear tubes in 2 weeks. I can’t wait -he needs these really badly. Needles to say, he has been sick since dec.He also has asthma,allergies and a VSD(hole in heart). He is a grumpy guy lately, and tired too. His cough is only when he gets up in the am, late at night while awake, or with too much crying/laughing/running around. Sleeps all night. He has no wheeze, I even had his lungs listened to at a walk in clinic yesterday. But his bad ear is red, as is his throat. So a few hrs after the visit to the clinic, I noticed it looked like he was blue/grey around his mouth, mustache area and to the side a bit, and a bit under his mouth. He soon after had a 3 hr nap, and does not look blue any longer. He has been napping a lot since becoming sick. He was done with naps about 18 months ago, so that is unusual. And his grumpiness is definitely illness related. What are the suggestions anyone has about the blueness? He currently takes singulair 4mg once daily, flovent 125 2 puffs twice daily, ventolin as needed. No meds for his heart. Thanks in advance for any advice

Answered by: Maria/MDHealthForum.com Team

We need oxygen for our body to sustain all of its vital functions. There are blood vessels that carry oxygenated blood to be utilized by the body’s organ systems. Once the oxygen has been used, the blood goes to the right half of the heart. First it goes to the right atrium- heart’s upper right chamber, then the blood will go to the right lower chamber (right ventricle). The right ventricle then contracts causing the blood to be pushed through the pulmonary artery- the blood vessel that brings blood to the lungs. When the blood reaches the lungs, the blood cells exchange carbon dioxide for oxygen. Once the blood has absorbed oxygen, it will go to the left half of the heart heart via the pulmonary vein. The oxygenated blood enters the upper left chamber of the heart which is called the left atrium. From the left atrium the blood will pass through valves then goes to the left ventricle which pumps the oxygen-rich blood to the rest of the body.

In ventricular septal defect, there is an opening between the ventricles because the ventricular septum- the wall between the ventricles, was not fully formed during the early stages of fetal development. Oxygenated blood in the left ventricle passes through the hole back to the right ventricle where it gets mixed with unoxygenated blood and then it will go back to the lungs. The back flow of blood will cause heart murmurs, enlarged ventricles and increase blood pressure to the lungs. Such problems may make it difficult for the lungs and heart to supply oxygen to the body. High pulmonary pressure will allow oxygen-poor blood to be pumped to the tissues will case symptoms like cyanosis- bluish discoloration of the skin, tiredness and breathing difficulties.

The severity of cyanosis may increase with crying, agitation and even with bowel movements. Another cause of breathing-related problems is when the airway is constricted as a reaction to allergens. Your child should always take his medications on time to prevent possible breathing difficulties. It is very important to immediately inform your child’s doctor about the episode of cyanosis that you have noticed. Treatment can prevent many of the serious complications of VSD, but prior to interventions, the doctor will examine your child first and may request for diagnostic procedures. Regular checkups and tests are recommended for children with VSD, this will allow the doctors to monitor whether the defect closes on it own or gets smaller.