A ventricular septal defect (VSD), a hole in the heart, is a common heart defect that’s present at birth (congenital). The hole (defect) occurs in the wall (septum) that separates the heart’s lower chambers (ventricles) and allows blood to pass from the left to the right side of the heart. The oxygen-rich blood then gets pumped back to the lungs instead of out to the body, causing the heart to work harder.
A small ventricular septal defect may cause no problems, and many small VSDs close on their own. Medium or larger VSDs may need surgical repair early in life to prevent complications.
Treatment of a VSD depends on a child’s age, as well as the size, location, and severity of the hole.
It’s important to note that VSDs do not get bigger, but sometimes they will get smaller or close completely on their own without any treatment. For this reason, the doctor may not immediately recommend surgery, but will watch your child closely and treat any symptoms with medication.
In general, small VSDs usually don’t cause symptoms and are more likely to close on their own. Many small VSDs will do so before your child is 2 years old.
Medium and large VSDs often result in noticeable symptoms such as fast breathing, tiring easily, poor feeding, and failure to gain weight and grow properly. These signs typically indicate that the VSD will not close by itself. In this case, your doctor may recommend heart surgery to fix the hole. The purpose of this surgery is to ease symptoms caused by the VSD and prevent long-term damage to the heart and lungs.
While infants and children most often receive this type of operation, adults sometimes also need the surgery if their VSD was not diagnosed during childhood.
Be sure to speak with your doctor about what treatment is right for your child. If surgery is recommended, your doctor will refer you to a cardiothoracic surgeon.
Signs and symptoms of serious heart defects often appear during the first few days, weeks or months of a child’s life.
Ventricular septal defect (VSD) symptoms in a baby may include:
You and your doctor may not notice signs of a ventricular septal defect at birth. If the defect is small, symptoms may not appear until later in childhood — if at all. Signs and symptoms vary depending on the size of the hole and other associated heart defects.
Your doctor may first suspect a heart defect during a regular checkup if he or she hears a murmur while listening to your baby’s heart with a stethoscope. Sometimes a VSD can be detected by ultrasound before the baby is born.
Sometimes a VSD isn’t detected until a person reaches adulthood. Symptoms and signs can include shortness of breath or a heart murmur your doctor hears when listening to your heart with a stethoscope.
Congenital heart defects arise from problems early in the heart’s development, but there’s often no clear cause. Genetics and environmental factors may play a role. VSDs can occur alone or with other congenital heart defects.
During fetal development, a ventricular septal defect occurs when the muscular wall separating the heart into left and right sides (septum) fails to form fully between the lower chambers of the heart (ventricles).
Normally, the right side of the heart pumps blood to the lungs to get oxygen; the left side pumps the oxygen-rich blood to the rest of the body. A VSD allows oxygenated blood to mix with deoxygenated blood, causing increased blood pressure and increased blood flow in the lung arteries. This results in increased work for the heart and lungs.
VSDs may be various sizes, and they can be present in several locations in the wall between the ventricles. There may be one or more VSD.
It’s also possible to acquire a VSD later in life, usually after a heart attack or as a complication following certain heart procedures.
Most children do well with VSD surgery. But complications do sometimes occur. Specific risk factors may vary based on age, the size of the defect, and other health problems. Possible risks include:
Late complications are also possible. But they are rare. These might include problems with the heart valves. Very rarely, the patch used to fix the defect might become loose. Then another surgery will be needed. Ask your child’s Medicare Spots about the specific risk factors for your child.
Ventricular septal defects (VSDs) often cause a heart murmur that your doctor can hear using a stethoscope. If your doctor hears a heart murmur or finds other signs or symptoms of a heart defect, he or she may order several tests including:
Certain pre-operative tests will be conducted before the surgery. These tests will include:
Hours before the surgery the patient will be asked not to eat or drink anything, to bathe and shave any hair off from the area where surgery will be performed. Special dress will be provided to the patient by the medical staff to wear during the surgery.
Many babies born with a small ventricular septal defect (VSD) won’t need surgery to close the hole. After birth, your doctor may want to observe your baby and treat symptoms while waiting to see if the defect closes on its own.
Babies who need surgical repair often have the procedure in their first year. Children and adults who have a medium or large ventricular septal defect or one that’s causing significant symptoms may need surgery to close the defect.
Some smaller ventricular septal defects are closed surgically to prevent complications related to their locations, such as damage to heart valves. Many people with small VSDs have productive lives with few related problems.
Babies who have large VSDs or who tire easily during feeding may need extra nutrition to help them grow. Some babies may require medication to help treat heart failure.
Medications for ventricular septal defect depend on the severity of heart failure symptoms. The goal of medication is to decrease the amount of fluid in circulation and in the lungs. Medications called diuretics, such as furosemide (Lasix), reduce how much blood must be pumped.
Surgical treatment for ventricular septal defect involves plugging or patching the abnormal opening between the ventricles. If you or your child is having surgery to repair a ventricular defect, consider having surgery performed by surgeons and cardiologists with training and expertise in conducting these procedures.
Procedures to treat VSD may include:
Ask your child’s healthcare provider what will happen after the VSD surgery. In most cases, the surgery will permanently cure the VSD. No activity restrictions will be needed. After the procedure in the hospital, you can generally expect the following:
Ask what medicines your child needs to take. Your child may temporarily need to take certain medicines after the surgery. Give pain medicines as needed.
Most children can get back to their normal activities when they get home. But they may tire more easily for a while. Children should avoid activities that might result in blows to the chest.
Your child may need to have stitches removed in a follow-up appointment. Be sure to keep all follow-up appointments.
Call your child’s healthcare provider if your child has increased swelling, increased bleeding or drainage, a fever, or severe symptoms. A little drainage from the site is normal.
Follow all the instructions your child’s healthcare provider gives you about medicine, exercise, diet, and wound care.
For a while after the procedure, your child might also need antibiotics before certain medical and dental procedures. They can help prevent an infection of the heart valves.
For a short time after the procedure, your child will need regular checkups by a cardiologist. After that, your child will need to see a cardiologist only now and then. After recovering from surgery, most children are able to lead normal lives without any activity restrictions.
A. Other heart problems such as leaking or narrowing heart valves could be common in patients suffering from VSD. Another complex heart problem associated with VSD is tetralogy of Fallot.
A. There is no exact reason as to why a VSD forms. Genes and environment certainly play a pivotal role. As we continue to learn more about the human DNA, we may come to a position to understand more about what causes ventricular septal defect (VSD).
A. In the womb the heart starts out as a single tube. As this tube loops, the two bottom tubes lie side-by-side and a wall (septum) develops to complete the division of the heart into left and right sides. The right side pumps blood to the lungs, and the left side pumps blood to the body. Sometimes this wall does not grow completely and a hole remains.
A. Ventricular septal defects (VSD) are generally considered to be non-life-threatening, usually closing by themselves or may cause symptoms such as congestive heart failure. Congestive heart failure can be treated surgically in time to save the patient’s life.
A. In most cases the ventricular septal defects are revealed after the birth of a child. By using a stethoscope the doctor can listen to the rumble of the blood as it goes through the hole. This is called a murmur. At times even if you place your hand on your chest, you will feel a rumbling. This is called a thrill. Some VSDs are not diagnosed until adulthood. Diagnosis of a VSD includes:
A. VSD can lead to high blood pressure in lungs and eventually can result in cardiac failure, if not treated in time.
A. Small VSD may never require any treatment. However, large VSDs might have the risk of developing other heart, lung, and blood problems.