Ventricular Septal Defect
A ventricular septal defect (VSD) is a hole in the wall between the heart's two 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.
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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. Some things that may play a role are:
- Changes in certain genes—may occur on their own or be passed down from a parent
- Illness or exposure during the mother’s pregnancy
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
Risk factors in the mother are:
A small VSD may not cause symptoms. A larger VSD may cause:
- Problems feeding
- Sweating while feeding
- Poor growth
- Fast breathing
- Breathing problems during activity
An imaging test may be done before birth to confirm the diagnosis. This can be done with a fetal echocardiogram.
In others, the doctor will ask about your baby’s symptoms and health history. A heart murmur may be heard during the physical exam. This may be enough to suspect VSD.
Images may be taken of the heart to confirm the diagnosis. This can be done with an echocardiogram.
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Most VSDs will close on their own. If there are no signs of heart failure, the best treatment may be to wait and for the doctor to watch for any changes.
Larger holes put an extra workload on the heart. They also cause higher blood pressure in the arteries of the lungs. These problems can lead to heart failure and lung damage. Activities will be limited. These holes will need to be treated.
A VSD is treated with one or more of these:
There are no known methods to prevent VSD.
Medicines can delay the need for surgery for severe VSD. They can also ease symptoms of heart failure.
Medicine may be used to:
- Relax the blood vessels
- Help the heart pump more effectively
- Reduce the workload on the heart
- Remove excess fluid from the body
- Lower blood pressure
Children who are not gaining weight may need extra nutrition. High-calorie formula, breast milk supplements, and tube feedings may be needed.
Surgery is needed to fix large VSDs that cause problems or that have not closed by 1 year of age. It will lower the risk of other heart-related problems in the future. The hole is fixed with a patch. Over time, the heart lining will grow over it. Options are:
- Percutaneous procedure: A tube is inserted into a blood vessel in the thigh and passed up to the heart. A patch is used to seal the hole in the heart.
- Open heart surgery: A large incision is made in the chest and a patch is used to close the hole.
Long Term Care
Lifetime monitoring will be needed. Problems can happen as a child gets older. Monitoring can help find problems before they happen. This may involve:
- A yearly exam with a heart specialist
- Regular tests of heart function
- Changes to the child's treatment plan
- Facts about ventricular septal defect. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/ncbddd/heartdefects/ventricularseptaldefect.html.
- Ventricular septal defect. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/ventricular-septal-defect.
- Ventricular septal defect (VSD). American Heart Association website. Available at: https://www.heart.org/en/health-topics/congenital-heart-defects/about-congenital-heart-defects/ventricular-septal-defect-vsd.
- Ventricular septal defect (VSD). Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/pediatrics/congenital-cardiovascular-anomalies/ventricular-septal-defect-vsd.
- Ventricular septal defect (VSD). UCSF Pediatric Cardiothoracic Surgery website. Available at: https://pedctsurgery.ucsf.edu/conditions--procedures/ventricular-septal-defect.aspx.
- Kari Kuenn, MD
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