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Ventricular Septal Defect (VSD)

A ventricular septal defect (VSD) is a hole in the wall (septum) of the heart that separates the lower chambers (ventricles). It is a common congenital (from birth) heart defect. The hole allows blood to pass from the left to the right side of the heart. This causes oxygen-rich blood to get pumped back to the lungs instead of out to the body. The heart has to work harder to give the body enough oxygen.

VSDs may be of various sizes, and they can be present in several locations in the septum. A small VSD may cause no problems and may even close on its own. Medium or larger VSDs likely need surgical repair.

It's also possible to acquire a VSD later in life, usually after a heart attack or as a complication following certain heart procedures.

What happens once you have ventricular septal defect (VSD)?

Signs and symptoms of serious heart defects often appear during the first few days, weeks, or months of a child's life.

Symptoms in a baby with VSD may include:

  • Easily tired.

  • Poor eating and failure to thrive.

  • Fast breathing or breathlessness.

If left untreated, complications from a VSD can include:

  • Heart failure: In a heart with a medium or large VSD, the heart works harder, and the lungs have too much blood pumped to them. Without treatment, heart failure can develop.

  • Pulmonary hypertension: Increased blood flow to the lungs due to the VSD causes high blood pressure in the lung arteries (pulmonary hypertension) can permanently damage them. This complication can cause a reversal of blood flow through the hole (Eisenmenger syndrome).

  • Endocarditis: Endocarditis is an infection of the heart lining, a heart valve, or a blood vessel. This is an uncommon complication.

  • Other heart problems: These include abnormal heart rhythms (arrhythmias) and valvular heart disease.

What causes ventricular septal defect (VSD)?

Congenital heart defects arise from problems early in the heart's development, but there's often no clear cause.

VSDs may run in families and sometimes may occur with other genetic problems, such as Down syndrome. If you already have a child with a heart defect, a genetic counselor can discuss the risk of your next child having one.

What types of tests are used to diagnosis ventricular septal defect (VSD)?

VSDs often cause a heart murmur that your doctor can hear using a stethoscope. To confirm the diagnosis, your doctor may order several tests, including:

  • Echocardiogram: In this test, sound waves produce a video image of the heart. Doctors may use this test to diagnose a VSD and determine its size, location, and severity.

  • Electrocardiogram (EKG): This test records the heart's electrical activity through electrodes attached to the skin and helps diagnose heart defects or rhythm problems.

  • Chest X-ray: An X-ray image helps the doctor view the heart and lungs to see if the heart is enlarged and if the lungs have extra fluid.

  • Cardiac catheterization: Through cardiac catheterization, doctors can diagnose congenital heart defects and determine the function of the heart valves and chambers

  • Pulse oximetry: A small clip on the fingertip measures the amount of oxygen in the blood.

What types of treatments and procedures are used to treat ventricular septal defect (VSD)?

Many babies born with a small 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 independently.

Babies who have large VSDs or who tire easily during feeding may need to be given extra nutrition with baby formula to help them grow. Medications may be used for VSD to decrease the amount of fluid in circulation and the lungs. Medications called diuretics (water pills) reduce how much blood must be pumped.

Surgical treatment involves plugging or patching the abnormal opening between the ventricles with open-heart surgery or catheterization. Catheterization doesn't require opening the chest. Rather, the doctor inserts a thin tube (catheter) into a blood vessel in the groin and guides it to the heart. The doctor then uses a mesh device to close the hole.

What can I do to support my health when I have ventricular septal defect (VSD)?

After the VSD is repaired, you or your child will need follow-up care throughout life for doctors to monitor your condition and check for any signs of complications.

Here are a few tips for managing your or your child's condition:

  • Consider pregnancy carefully. Before becoming pregnant, talk to a doctor trained in heart conditions (cardiologist) to determine if you can undergo pregnancy safely.

  • Prevent endocarditis. Your doctor may recommend antibiotics before dental care if you've had prior endocarditis, a heart valve replacement, or VSD repair with artificial material.

  • Follow exercise recommendations. Your doctor can advise you about which activities are safe for you or your child. Children with VSDs can lead healthy, fully active, productive lives. Children with small defects or a repaired hole in the heart will usually have few or no restrictions on activity or exercise.

Why choose Presbyterian for ventricular septal defect (VSD) treatment?

Presbyterian’s Pediatric and Congenital Cardiology team has many different options to help you manage your or your child’s heart condition. The team performs various diagnostic tests and procedures to help form an accurate diagnosis and create individualized treatment plans. Depending on the type of heart condition your child has and its underlying cause, the team can recommend a wide variety of treatment options. Our pediatric cardiologists, pediatric interventional cardiologists, and pediatric cardiovascular surgeons work closely together for cases in which cardiac repair or surgery is the best treatment option.