Overview of a ventricular septal defect
Ventricular septal defect (congenital) is a common congenital heart defect. The hole (defect) occurs in the wall (septum), which separates the lower chambers (ventricles) of the heart and allows blood to flow from the left to the right side of the heart. Excess oxygenated blood is sent back to the lungs instead of outside the body, causing the heart to work harder.
A small ventricular septal defect does not cause problems, and most small VSDs close on their own. Medium or large VSDs may require surgical repair early in life to prevent complications.
How does it affect the heart?
Normally, the left side of the heart only sends blood to the body and the right side of the heart only sends blood to the lungs. In children with VSD, blood can travel from the left pumping chamber (left ventricle) to the right pumping chamber (right ventricle) and through the orifice into the pulmonary arteries. If the VSD is large, the excess blood is pumped into the pulmonary arteries, causing the heart and lungs to work harder and the lungs to become congested.
How does VSD affect the baby?
If the opening is small, it won’t cause symptoms because the heart and lungs don’t need to work hard. The only unusual finding is a loud murmur (sound heard with a stethoscope).
If the opening is large, the child may breathe faster and harder than normal. Babies may have trouble feeding and growing at a normal rate. Symptoms may not appear until several weeks after birth. High pressure can occur in the blood vessels of the lungs because more blood is pumped than normal. Over time, it can cause permanent damage to the blood vessels in the lungs.
What are the symptoms of VSD?
People with VSDs may not have symptoms. However, if the hole is large, the baby often has symptoms related to heart failure.
The most common symptoms include:
- Shortness of breath
- Fast breathing
- Hard breathing
- Failure to gain weight
- Fast heart rate
- Sweating while feeding
- Frequent respiratory infections
Causes of the ventricular septal defect
Congenital heart defects arise from early complications of cardiac development, but often for no apparent reason. Genetic and environmental factors play a role. VSDs can occur alone or with other congenital heart defects.
During fetal development, VSD occurs when the muscular wall that separates the heart from the left and right sides (septum) does not form completely between the lower chambers (ventricles) of the heart.
Normally, the right side of the heart sends blood to the lungs to receive oxygen. The left side sends oxygen-rich blood to the rest of the body. A VSD allows oxygenated blood to mix with deoxygenated blood, causing the heart to work harder to provide enough oxygen to the body’s tissues.
VSDs can be of different sizes and are located in many places on the wall between the ventricles. There may be one or more VSDs. It’s also possible to get VSD later in life, usually after a heart attack or as a problem after certain heart procedures.
Ventricular septal defect risk factors
Ventricular septum defects run in families and can sometimes occur with other genetic problems, such as Down syndrome. If you already have a child with a heart defect, a genetic counsellor can discuss the risk for your next child.
By listening to your child’s heart with a stethoscope, your child’s healthcare provider may suspect a problem when they hear an abnormal sound (heart murmur). If this happens, the healthcare provider may refer your child to a pediatric cardiologist (pediatric cardiologist).
The cardiologist will examine your baby. You will listen to your child’s heart and lungs. Details about the murmur can help the cardiologist make a diagnosis.
The cardiologist can perform tests to confirm the diagnosis. Your child’s tests will depend on her age and condition and the doctor’s preferences.
The chest x-ray shows the heart and lungs. With VSD, a chest X-ray shows an enlarged heart. This is because the left ventricle receives more blood than normal. There may also be changes in the lungs due to excess blood flow.
This test records the electrical activity of the heart. It also shows abnormal rhythms (arrhythmia) and heart muscle tension.
It uses resonant sound waves to create a moving image of the heart and heart valves. This test shows the pattern and amount of blood flow through the septum opening. An echo is used to diagnose VSD.
Treatment for ventricular septal defect
Most babies born with a small ventricular septal defect (VSD) do not require surgery to close the hole. After birth, your doctor may observe your baby and want to treat the symptoms, but it remains to be seen if the defect will close on its own.
Children who need surgical repair will have this procedure for the first year. Children and adults with a medium or large ventricular septal defect or those causing significant symptoms may need surgery to close the defect.
Some small ventricular septal defects are surgically closed to avoid problems with their placement, such as damage to the heart valves. Most people with minor VSDs lead productive lives with some related problems.
Medications for ventricular septal defect may include:
- Vasodilators: Angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers are used to decrease the workload on the left ventricle.
- Digoxin (Lanoxin) increases the strength of the heart muscle to deal with the greater blood volume.
- Diuretics such as Lasix (furosemide) or spironolactone help remove excess fluid from the body so the heart doesn’t have to work as hard and the patient feels much better.
Lifestyle and home remedies
Once the ventricular septal defect (VSD) is repaired, you or your baby will need lifelong follow-up care to monitor your condition and have doctors look for signs of problems.
Your doctor may recommend that you or your baby make regular subsequent appointments with a doctor who specializes in congenital heart disease. At subsequent appointments, your doctor may evaluate you or your baby and order imaging tests to monitor your or your baby’s condition.
Here are some tips to help you manage your / your child’s condition:
Examine the pregnancy carefully. Before you get pregnant, talk to a trained cardiologist to find out if you can safely conceive. This is especially important if you are taking medication. It is also important to see an obstetrician and a cardiologist during pregnancy.
Prevents endocarditis. You or your baby usually do not need to take antibiotics before certain dental procedures to prevent infection of the lining of the heart (endocarditis).
However, if you have endocarditis before you have replaced the heart valve if you have recently repaired the VSD with synthetic material if you are still leaking through the VSD, your doctor may recommend antibiotics.
Ventricular septal defect complications
A small defect of the ventricular septum never causes any problems. Medium or large defects can cause a wide variety of deformities, from mild to malignant. Treatment can prevent many problems.
- Heart failure. medium or large VSD, the heart must work harder to supply enough blood to the body. Because of this, large, medium to large VSDs can cause heart failure if left untreated.
- Pulmonary hypertension. The increased blood flow to the lungs due to VSD causes high blood pressure in the pulmonary arteries (pulmonary hypertension), which permanently damages them. This problem causes blood to flow through the hole (Eisenmenger syndrome) to reverse.
Women can do nothing during pregnancy to prevent their babies from developing a ventricular septal defect.