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Will PREMATURE BIRTH lead to HEART PROBLEM in future?

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I'm a 25yr old male, 5,10" 165 lbs, don't drink/smoke/do drugs. My only substantial medical history was the fact that I was born 7 weeks premature.

I saw a few articles that stated being born premature could lead to heart problems (among others) later in life. Specifically, the structure of the heart MIGHT be abnormal (seems like mainly the ventricles).

Other than being premature, I've had good health all my life. For a while, my blood pressure was slightly high - into the 130s - but diet/exercise/caffeine reduction has it to normal range. I don't have any of the complications of being born premature I've heard that can be carried into adult life (my vision, height/weight, cognitive abilities, lung function, etc have always been great). As it turns out, I also had quite the cardio work up after a spell of anxiety/anxiety attacks (which definitely runs in my family). I had ekgs, blood work, event monitor, a full physical from a great cardiologist and an exercise stress test. Also went through thorough medical & family history with the cardiologist. Everything checked out. In fact, in the cardiologists' words, I passed everything with flying colors.
So here's my question.. Could I have something wrong with my heart after all of the tests? And how likely would some heart issue be for an adult born prematurely? The articles I read we're very vague on numbers, they only said it might be another risk factor for heart disease.

I don't think I'm in any immediate danger (especially with the stress test). But I want to know if I should be following up with the cardiologist or perhaps another Dr. about future concerns.

Thank you in advance for any input.


Category: Cardiologist

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Category: Cardiologist
Dr. Vivek Mahajan is online now

Expert:  Dr. Vivek Mahajan replied 4 Days.

Hello,
Thank you for your query at DoctorSpring.com
I understand your concern.
Yes there were some isolated studies claiming that structually the right chamber ( ventricle of the heart ), was slightly smaller and thicker in premature babies, but a lot of experiments have been done, and cutting edge MRI investigations, have failed to show any significant changes in babies born prematurely or full term. That too 7 weeks prematurity does not really pose any problems, and since all of your tests are normal you have absolutely nothing to worry about.
Some premature babies who are born too early face such issues like PDA ( Patent Ductus ), or other valve defects which particularly can persist in the future, however those babies are born before 10-12 weeks of expected delivery. In your case again it is 7 weeks, and hence we should not worry, also the tests would have definitely evaluated your heart valves, and anything wrong would have showed up. I am assuming your cardiologist must have done ECHO.
Just make sure with diet and adequate exercise, your BP is under control.
Let me know if i can help you further,
Regards.


Patient replied :

Thank you very much for the reply, it helps put my mind at ease. The articles I read we're very vague and made it sound like ALL premature babies would have heart abnormalities, regardless of how early they were born.

I have just a few follow up questions. My Cardiologist knew my full health history but did not have me do the Echo (I specifically asked about it). He said quite confidently that he would be able to hear a valve abnormality with the stethoscope and that the stress test would be better. (I had several doctors check and I definitely do not have a murmur).

Is the stress test (along with the other tests) enough to determine that my heart is healthy? (Including ventricles and valves?) My stress test results were very good - the cardiologist said that my heart responded well to exercise and had good blood flow. This was just a standard stress test with EKG and BP monitor.
Do you think I need to have an echocardiogram?
Thank you again.


Expert:  Dr. Vivek Mahajan replied 3 Days.

Hello,
Yes the articles you went through are definitely misleading. Actually there are so many claims, all over the world, however most of these claims have been proved inconclusive after a lot of research. Same is the case for premature babies and Heart Disorders.
A good cardiologist can hear murmurs, arising in case of defective heart valves, and also invariably there will be symptoms like shortness of breath, chest pain, e.t.c on presentation. Hence after auscultation, since he could not hear anything he did not ask for an echo.
A good stress test definitely points towards a healthy heart and you do not need any further investigations.
Kindly do not worry. You definitely have a strong heart.
Wish you great health!
Let me know if this conversation was helpful.
Regards.


Patient replied :

I don't have any further questions, I just wanted to thank you for the information and the quick replies. You have been a great help, thank you!


Expert:  Dr. Vivek Mahajan replied 2 Days.

I am glad i was helpful.
You can always get back to me for future queries.
Regards.


Patient replied :

I'm sorry to bother you again but, by any chance is there a source you can find that disproves premature birth affecting ventricle size and thickness? I've been unable to find anything so far. Even if it's just pointing me in the right direction, it would be a great help.

Thanks once again.


Expert:  Dr. Vivek Mahajan replied 1 Day.

Hello,
http://oxfordbrc.nihr.ac.uk/premature-babies-found-to-have-smaller-hearts-in-later-life/
If you go through the article carefully, it clearly says that in patients born premature, their right ventricle will have slightly more thickness compared to normal population. But even if that is the case, there is nothing new discovered that seems to be worrying. The only thing such people are prone for is hypertension, but again we can't really predict that because ultimately most people end up with hypertension. So that is also not a cause of worry, it just says that such people are slightly more prone for hypertension. But with adeqaute diet and exercise, that can definitely be controlled.
Moreover you already had a stress test done. If you had a thicker ventricle, your BP would have raised up by significant numbers, and your doctor would have pointed that out. Also note not everyone who is born premature has a thicker right ventricle. Only a few people. But as a doctor, once again i reassure you, it is not going to cause any harm.
Regards.


Dr. Vivek Mahajan
Category: Cardiologist
Experience: 
Fellowship: DM, Cardiology, PGIMER, 2013
Residency: MD, Internal Medicine, AIIMS, 2007
Internship: King Edward Memorial (KEM) Hospital, 2003 
Medical School: MBBS, Seth G.S. Medical College, 2002
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