Ventricular septal defect is a congenital heart condition that causes a hole in the ventricular septum, the wall that divides the two ventricles (lower chambers) in the heart. The defect can occur at any place in the septum and allows oxygen-poor blood returning from the body to mix with oxygen-rich blood flowing to the body. VSD affects how efficiently the heart pumps blood, causes higher blood pressure than normal in the blood vessels of the lungs and forces the right side of the heart to pump harder. Without treatment, children who have a large ventricular septal defect may develop lung disease. Treatment options can be effective and allow your child to have an active life.

Wellness & Prevention

A small to medium ventricular septal defect may not cause any problems or symptoms and may close on its own. A large ventricular septal defect can seriously affect how the heart functions and could lead to congestive heart failure. A VSD allows oxygen-rich blood from the left ventricle to flow into the right ventricle that should only contain oxygen-poor blood headed for the lungs. The right side of the heart then has to pump more vigorously to send the extra blood to the lungs. The higher volume of blood raises the pressure in the blood vessels of the lungs. With time, the extra pressure can cause lung disease.

A ventricular septal defect also causes areas of high and low pressure in the heart. As the pressure in the right side exceeds the left, oxygen-poor blood more easily flows into the left ventricle and gets pumped to the body, delivering inadequate oxygen to tissue and organs.

What causes a ventricular septal defect isn’t known but the defect develops as the heart forms in the first eight weeks of pregnancy. Your baby’s risk for VSD may be higher if there is a family history of heart defects. Ventricular septal defect can occur with other heart defects, such as tetralogy of Fallot and transposition of the great arteries.

A child born with a ventricular septal defect may have symptoms while still in infancy. Symptoms vary depending on the severity of VSD but may include:

  • Poor weight gain or growth
  • Rapid, heavy or congested breathing
  • Fatigue
  • Sweating
  • Trouble feeding
  • Fast heart rate

Diagnosis

Your obstetrician may detect a ventricular septal defect during an ultrasound while your baby is still developing. After birth, your baby’s doctor may hear a heart murmur, the noise caused by turbulent blood flow. To confirm a ventricular septal defect, a pediatric cardiologist may run different tests including:

  • Chest X-ray: An X-ray produces an image that shows the shape, structure and size of your baby’s heart and lungs, including an enlarged heart and changes to the lungs caused by VSD.
  • Electrocardiogram (ECG or EKG): An electrocardiogram records how the electrical conduction system in the heart is working to trigger and coordinate each contraction. An ECG detects arrhythmias and heart muscle stress.
  • Echocardiogram: Using recorded sound waves, an echocardiogram creates a moving picture of the heart. An echocardiogram can detect a ventricular septal defect, the size of the hole, how much blood flows through it and how blood is moving through the defect.
  • Cardiac catheterization: Blood pressure and oxygen measurements in the heart are taken throughout the heart with a tiny tube inserted through a larger blood vessel and guided into the heart. Cardiac catheterization can also be used to inject contrast dye to make the heart’s structures more visible.
  • Your pediatric cardiologist may also perform a pulse oximeter or oxygen saturation test to measure oxygen in the bloodstream.

Treatments

Small ventricular septal defects may close on their own without treatment. Treatment options for larger VSDs include:

  • Medication: Your pediatric cardiologist may prescribe digoxin to strengthen the heart’s contractions and maintain a regular heartbeat, a diuretic to alleviate fluid retention in the lungs and body and ACE inhibitors to lower blood pressure. Beta blockers may also be used to regulate your child’s heartbeat.
  • Surgery: A pediatric cardiac surgeon can close, patch or plug a ventricular septal defect during surgery. Your child may have open-heart surgery, cardiac catheterization or a hybrid procedure using both techniques to repair the VSD.

Aftercare

After repairing the defect, your pediatric cardiologist may recommend that your child take antibiotics for a while to prevent infective endocarditis. Once they recover from treatment, most children who had a ventricular septal defect are able to be active without any restrictions. Your child may need periodic check ups with a pediatric cardiologist to make sure the heart is functioning well.