A ventricular septal defect (VSD) is a heart defect. It’s congenital. This means that your baby is born with it. A VSD is an opening or hole in the dividing wall (septum) between the two lower chambers of the heart (right and left ventricles). VSDs are the most common type of congenital heart defect.
A VSD allows oxygen-rich (red) blood to pass from the left ventricle through the opening in the septum. Then it mixes with oxygen-poor (blue) blood in the right ventricle.
There are different types of VSD. The type your child has depends on which part of the wall between the ventricles is involved. The size of the opening or hole also varies.
VSD may occur more often in some families. This is because of gene defects. Most of the time, the cause of VSD isn’t known.
The size of the opening or hole affects how severe your child’s symptoms are. So does the age at which your child first has symptoms. The larger the opening, the more blood passes through it. The right ventricle and lungs have to work harder.
Your child may have symptoms from birth. Or your child may not have symptoms until he or she is a little older. Symptoms can occur a bit differently in each child. They can include:
The symptoms of VSD may be similar to symptoms of other conditions. Make sure your child sees his or her healthcare provider for a diagnosis.
Your child's healthcare provider may suspect this issue when he or she hears an abnormal sound (heart murmur) when listening to your child's heart with a stethoscope. If this happens, the healthcare provider may refer your child to a heart doctor for children (pediatric cardiologist).
The heart doctor will check your baby. He or she will listen to your child’s heart and lungs. The details about the murmur will also help the heart doctor make the diagnosis.
Your child’s doctor may do tests to confirm the diagnosis. The tests your child has depends on his or her age and condition, and the doctor’s preferences.
A chest X-ray shows the heart and lungs. With a VSD, a chest X-ray may show an enlarged heart. This is because the left ventricle gets more blood than normal. There may also be changes in the lungs because of extra blood flow.
This test records the electrical activity of the heart. It also shows abnormal rhythms (arrhythmias or dysrhythmias) and spots heart muscle stress.
An echo uses sound waves to make a moving picture of the heart and heart valves. This test can show the pattern and amount of blood flow through the septal opening. An echo is often used to diagnose VSD.
A cardiac catheterization gives detailed information about the structures inside the heart. In this test, a small, thin, flexible tube (catheter) is put into a blood vessel in your child’s groin. Then the healthcare provider guides it to your child’s heart. Your child’s healthcare provider will inject your child with contrast dye to see his or her heart more clearly. This test measures your child’s blood pressure and oxygen in the 4 chambers of the heart and the pulmonary artery and aorta. Your child will get medicine to help relax and prevent pain (sedation). This test often isn’t needed if your child is diagnosed with an echo.
Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.
Small VSDs may close on their own as your child grows. Some small defects don’t close on their own, but they still don’t need treatment. A larger VSD often needs to be fixed with surgery or through cardiac catheterization. Once children are diagnosed with a VSD, their heart doctor will check them regularly to see if it’s closing on its own.
Some children may need to take medicine to help the heart work better. Children without symptoms may not need medicine.
Infants with a larger VSD may get tired when feeding. They may not be able to eat enough to gain weight. They may need:
The goal of surgery is to repair the septal opening before the lungs are damaged. Surgery will also help infants who have trouble feeding gain a normal amount of weight. Your child's heart doctor will decide when your child should have surgery. This may be based on echocardiogram and cardiac catheterization results. In surgery, your child’s doctor will close the VSD with stitches or a special patch. Ask your child’s heart doctor for more information.
VSD may be repaired by a cardiac catheterization. In this test, an instrument called a septal occluder is used with a catheter. The healthcare provider guides the catheter through the blood vessels to the heart. Once the catheter is in the heart, the doctor uses the septal occluder to close the defect.
Complications of an untreated VSD include:
Infants with small VSDs may have no symptoms. These children may not need medicine. They’ll still be checked often by their heart doctors. If a defect is going to close, it usually happens by 2 years of age. But some defects don’t close until 4 years of age. These children usually grow and develop normally. They also have no activity restrictions, and live normal, healthy lives.
If the VSD is moderate to severe, your child’s heart doctor will closely monitor him or her. The doctor will decide when and how your child’s VSD will be fixed. Before surgery, your child may need medicine and special feedings. Your child's healthcare team will give you information and support so you can care for your child at home. Children who need surgery will be admitted to the hospital for surgery.
Babies who have trouble eating before surgery often have more energy right after surgery. They start to eat better and gain weight faster.
After surgery, older children can often be active without getting too tired. Within a few weeks, your child should be fully recovered. He or she should be able to do normal activities. Your child’s healthcare team may give you instructions on how to care for your child.
Most children who have surgery for VSD will live normal, healthy lives. Their activity levels, appetite, and growth often return to normal. Your child's heart doctor may give him or her antibiotics to prevent infections after leaving the hospital.
Ask your child's healthcare provider about your child’s outlook. When this condition is diagnosed early, the outcome is often excellent. When a VSD is diagnosed later in life, if complications occur after surgery, or if the VSD isn’t repaired, the outlook may be poor. There is a risk for complications from a VSD. Children at risk for these problems should have follow-up care at a center that specializes in congenital heart disease.
If your child has trouble breathing or eating, or develops any new symptoms, call his or her healthcare provider.
Tips to help you get the most from a visit to your child’s healthcare provider: