Ventricular septal defect (VSD)
Ventricular septal defect (VSD)
A ventricular septal defect (VSD), also called a hole in the heart, is a common heart defect that's present at birth (congenital).
A baby with a small ventricular septal defect may have no problems. A baby with a larger ventricular septal defect or associated heart defects may have a telltale bluish tint to the skin — due to oxygen-poor blood — often most visible in the lips and fingernails.
Fortunately, ventricular septal defect is readily treatable. Smaller ventricular septal defects often close on their own or don't cause problems. Others need surgical repair, sometimes not until the condition is first detected or symptoms first develop in adulthood. Many people with ventricular septal defects have normal, productive lives with few related problems.
Signs and symptoms of serious heart defects often appear during the first few days, weeks and months of a child's life.
Signs and symptoms of a large ventricular septal defect in a baby may include:
Although these signs can be caused by other conditions, they may be due to a congenital heart defect.
You and your doctor may not notice signs of a ventricular septal defect at birth. If the defect is small, symptoms may not appear until later in childhood — if ever. Signs and symptoms vary depending on the size of the hole. Your doctor may first suspect a heart defect during a regular checkup while listening to your baby's heart with a stethoscope.
Sometimes a ventricular septal defect isn't detected until a person reaches adulthood and develops signs or symptoms of heart failure, such as shortness of breath.
When to see a doctor
Call your doctor if you develop:
Heart defects that are present at birth (congenital) arise from errors early in the heart's development, but there's often no clear cause. Genetics and environmental factors probably play a role.
A ventricular septal defect occurs when the septum, the muscular wall separating the heart into left and right sides, fails to form fully between the lower chambers of the heart (ventricles) during fetal development. This leaves an opening that allows mixing of new ("red," or oxygenated) blood and used ("blue," or deoxygenated) blood.
As a result, blood overfills the lungs and overworks the heart. If the defect is severe and not treated, the blood pressure in the lungs goes up (pulmonary hypertension) and the ventricles enlarge and no longer work efficiently. Ultimately, this can lead to irreversible damage to the lung arteries and to heart failure.
Ventricular septal defect
A ventricular septal defect is an abnormal opening between the heart's lower pumping chambers. It's a common congenital heart defect that may heal on its own or require treatment to repair. ...
Ventricular septal defect appears to run in families and sometimes occurs with other genetic problems, such as Down syndrome. If you already have a child with a heart defect, a genetic counselor can predict the approximate odds that your next child will have one.
Having the following conditions during pregnancy can increase your risk of having a baby with a heart defect.
A small ventricular septal defect may never cause any problems. Larger defects can cause a wide range of disabilities — from mild to life-threatening. Treatment can prevent many of these complications.
This complication, called Eisenmenger's syndrome, may occur in early childhood, or it can develop slowly over many years. In people with Eisenmenger's syndrome, the majority of the blood flow through the ventricular septal defect goes from the right ventricle to the left and bypasses the lungs. This means deoxygenated blood is pumped to the body and leads to a bluish discoloration of the lips, fingers and toes (cyanosis) and other complications. Once a person has Eisenmenger's syndrome, it's too late to surgically repair the hole because irreversible damage to the lung arteries has already occurred.
Ventricular septal defect and pregnancy
Women born with a heart defect may also be concerned about the risk that the baby will be born with a heart defect as well. A woman without congenital heart disease has about a 1 percent chance of giving birth to a child with a heart defect. According to the American Heart Association, that risk increases to between 2 and 20 percent for a woman with congenital heart disease.
Doctors recommend that any woman with a congenital heart defect, repaired or not, who is considering pregnancy carefully discuss it beforehand with a cardiologist. This is especially important if you're taking medications. It's also important to see both an obstetrician and a cardiologist during pregnancy.
Preparing for your appointment
If you or your child develops signs and symptoms common to ventricular septal defect, call your doctor. After an initial examination, it's likely that the doctor will refer you or your child to a doctor who specializes in the diagnosis and treatment of heart conditions (cardiologist).
Here's some information to help you prepare for your appointment, and what to expect from your doctor.
What you can do
Questions to ask the doctor at the initial appointment include:
Questions to ask if you are referred to a cardiologist include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.
What to expect from your doctor
If you are the person affected:
If your baby or child is affected:
Tests and diagnosis
Ventricular septal defects often cause a heart murmur that your doctor can hear using a stethoscope. If your doctor hears a heart murmur or finds other signs or symptoms of a heart defect, he or she may request one or more of these tests:
Treatments and drugs
Many babies born with a small ventricular septal defect won't ever need to have the defect surgically closed. After birth, your doctor may want to observe your baby and treat any symptoms while waiting to see if the defect will close on its own.
Children and adults who have a ventricular septal defect that is large or is causing significant symptoms usually need surgery to close the defect. If your baby has a ventricular septal defect that needs surgical repair, the procedure will likely be scheduled in your baby's first year of life.
After repair, your doctor will schedule regular medical follow-up to ensure that the ventricular septal defect remains closed. Depending on the size of the ventricular septal defect and the presence or absence of any other problems, your doctor will tell you how frequently you or your child will need to be seen.
Surgery to close a ventricular septal defect generally has excellent long-term results.
Your doctor may still recommend preventive antibiotics if you:
For most people with a ventricular septal defect, practicing good oral hygiene and getting regular dental checkups is the most effective strategy for preventing endocarditis.
Coping and support
Parents of children with congenital heart defects often worry about the risks of rough play and vigorous activity even after successful treatment.
Children with small defects or a repaired hole in the heart will usually have few or no restrictions on activity or exercise. Children whose hearts have reduced pumping ability will need to follow some limits. A child with irreversible pulmonary hypertension (Eisenmenger's syndrome) has the greatest number of restrictions.
Your doctor can advise you about which activities are safe for your child. If some activities pose special dangers, encourage your child in other pursuits instead of focusing on what he or she can't do. Although every circumstance is different, remember that many children with ventricular septal defects grow up to lead healthy, productive lives.
It may also be helpful to join a support group for families of children born with heart defects. Support groups can offer practical advice and useful resources to help parents, families and caregivers find answers, connect with other families, and share their hopes and concerns with others facing similar challenges.
In most cases, you can't do anything to prevent having a baby with a ventricular septal defect. However, it's important to do everything possible to have a healthy pregnancy. Here are the basics:
If you have a family history of heart defects or other genetic disorders, consider talking with a genetic counselor before getting pregnant.
Last Updated: 2009-11-17
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