Definition

A ventricular septal defect (VSD) is a hole in the wall between the heart's 2 lower chambers. It can change the way blood flows in the heart and make the heart work harder. This can make the right side of the heart larger and cause problems in the lungs.

Ventricular Septal Defect Copyright © Nucleus Medical Media, Inc.

Causes

A VSD happens as the baby grows in the uterus. A specific area of the heart does not develop as it should. It is not always known why this happens. Factors that may play a role include:

• Changes in certain genes—may occur on their own or be passed down from parent
• Illness or exposure during the mother’s pregnancy

Some VSDs can occur after a heart attack or trauma. This is rare.

Risk Factors

A baby’s chances of a VSD may be higher if they have:

• A family history of septal defects
• Genetic disorders such as Down syndrome, DiGeorge syndrome or Turner syndrome

Factors that increase risk based on the mother include:

• Drinking alcohol during pregnancy
• Untreated health issues such as diabetes or phenylketonuria (PKU)
• Infections such as rubella
• Using certain medicines such as lithium or phenytoin

Symptoms

A small VSD may not cause symptoms. Larger VSD may cause:

• Difficulty feeding or sweating while feeding
• Poor growth
• Fast breathing
• Fainting
• Breathing problems during activity

Diagnosis

The doctor will ask about your baby’s symptoms and past health. A heart murmur may be heard during the physical exam. The doctor may suspect a heart issue based on symptoms and the murmur.

Tests may include:

• Echocardiogram —to confirm diagnosis
• Cardiac catheterization —to look at the heart and blood supply (not used for everyone)
• MR angiography —to look for the VSD

Cardiac Catheterization Copyright © Nucleus Medical Media, Inc.

Treatment

Treatment depends on the size of the hole and the problems it's causing. Smaller holes may not need to be treated. They may shrink or close on their own.

Larger holes put an extra workload on the heart. It also causes higher blood pressure in the arteries of the lungs. These problems can lead to heart failure and lung damage. If your baby has these problems, they will need to be treated. A larger hole can be closed with surgery.

A VSD is treated with one or more of these:

Prevention

There is no way to prevent VSDs since the cause is unknown.