In this heart problem present at birth, there is a hole between the two lower heart chambers. Know the symptoms and when surgery is needed.
A ventricular septal defect (VSD) is a hole in the heart. It's a common heart problem present at birth (congenital heart defect). The hole occurs in the wall that separates the heart's lower chambers (ventricles).
A VSD changes how blood flows through the heart and lungs. Oxygen-rich blood gets pumped back to the lungs instead of out to the body. The oxygen-rich blood mixes with oxygen-poor blood. These changes may increase blood pressure in the lungs and require the heart to work harder to pump blood.
A small ventricular septal defect may cause no problems. Many small VSDs close on their own. Babies with medium or larger VSDs may need surgery early in life to prevent complications.
A ventricular septal defect (VSD) is a hole in the heart that's present at birth (congenital heart defect). The hole is between the lower heart chambers (right and left ventricles). It allows oxygen-rich blood to move back into the lungs instead of being pumped to the rest of the body.
Symptoms of serious heart problems present at birth (congenital heart defects) often appear during the first few days, weeks or months of a child's life.
Symptoms of a ventricular septal defect (VSD) depend on the size of the hole and if there are any other heart problems. A small VSD may never cause symptoms.
In general, VSD symptoms in a baby may include:
Symptoms of a ventricular septal defect in adults may include:
Call your health care provider if your baby:
Call your provider if these symptoms develop:
Ventricular septal defect (VSD) occurs as the baby's heart is developing during pregnancy. The muscular wall separating the heart into left and right sides doesn't form fully, leaving one or more holes. The size of the hole or holes can vary.
There's often no clear cause. Genetics and environmental factors may play a role. VSDs can occur alone or with other heart problems present at birth. Rarely, a ventricular septal defect can occur later in life after a heart attack or certain heart procedures.
To understand more about ventricular septal defect (VSD), it may be helpful to know how the heart typically works.
The typical heart is made of four chambers — two upper chambers (atria) and two lower chambers (ventricles).
A ventricular septal defect changes the direction of blood flow in the heart and lungs. The hole lets oxygen-rich blood go back into the lungs, instead of going out to the body. Oxygen-rich blood and oxygen-poor blood now mix together. If the ventricular septal defect is large, the blood pressure in the lung arteries may increase. The heart then must work harder to pump blood. A large VSD can also increase the amount of blood flow in the lung arteries, causing congestion.
A typical heart has two upper and two lower chambers. The upper chambers, the right and left atria, receive incoming blood. The lower chambers, the more muscular right and left ventricles, pump blood out of the heart. The heart valves, which keep blood flowing in the right direction, are gates at the chamber openings.
Risk factors for ventricular septal defect include:
A baby born with ventricular septal defect may have other heart problems, such as:
If you already have a child with a congenital heart defect, a genetic counselor can discuss the risk of your next child having one.
A small ventricular septal defect (VSD) may never cause any problems. Some medium or large VSDs may be life-threatening. Treatment can help prevent many complications.
Complications of ventricular septal defect can include:
Because the cause is unclear, it may not be possible to prevent ventricular septal defect (VSD). But getting good prenatal care is important. If you have a VSD and are planning to become pregnant, schedule a visit with your health care provider and follow these steps:
If you have a family history of heart problems present at birth, consider talking with a genetic counselor and a heart doctor (cardiologist) before getting pregnant.
Some ventricular septal defects (VSDs) are diagnosed soon after a child is born. However, VSDs may not be diagnosed until later in life. Sometimes a VSD can be detected by a pregnancy ultrasound before the baby is born.
If ventricular septal defect is present, the health care provider may hear a whooshing sound (heart murmur) when listening to the heart with a stethoscope.
Tests that are done to help diagnose ventricular septal defect include:
Ventricular septal defect treatment may include regular health checkups, medications and surgery. Many babies born with a small ventricular septal defect (VSD) won't need surgery to close the hole. Some small VSDs close on their own.
If the VSD is small, regular health checkups may be all that's needed. Medication may be prescribed to treat any symptoms.
Babies who have large VSDs or who tire easily during feeding may need extra nutrition to help them grow. Some babies may require medication to help treat heart failure symptoms.
Medications won't repair a ventricular septal defect, but they may be given to treat symptoms or complications. The specific medications used depend on the symptoms and their cause. Water pills (diuretics) are used to decrease the amount of fluid in the body and reduce the strain on the heart.
Oxygen may be given.
Surgery may be done if the VSD is medium or large or if it's causing severe symptoms. Babies who need surgery to repair the hole often have the procedure in their first year.
A surgeon may close small ventricular septal defects if their location in the heart could cause damage to nearby structures, such as the heart valves.
Surgeries and procedures to repair a ventricular septal defect include:
After ventricular septal defect surgery, regular checkups are needed for life, ideally by a heart doctor (cardiologist). Checkups often include imaging tests to determine how well surgery is working.
Lifestyle changes may be recommended to keep the heart healthy and prevent complications.
Prevent heart infections. Sometimes heart problems can increase the risk of infection in the lining of the heart or heart valves (endocarditis). Antibiotics may be recommended before dental procedures if you have low oxygen due to a large VSD. The medicines may also be recommended if you have a surgically repaired VSD with a patch that still has some blood flow across it. Antibiotics may also be recommended if you recently had catheter-based VSD repair.
For most people with a ventricular septal defect, good oral hygiene and regular dental checkups can prevent endocarditis.
Talk to your provider before getting pregnant. If you have a ventricular septal defect and are pregnant or hoping to be, talk to your health care provider about the possible risks and complications. Together you can discuss and plan for any special care needed during pregnancy.
A small VSD or a repaired one without complications doesn't pose a large additional pregnancy risk. However, a large, unrepaired VSD, irregular heart rhythms, heart failure or pulmonary hypertension increase the risk for pregnancy complications.
Pregnancy is considered very high risk for those with Eisenmenger syndrome and is not recommended.
You may find that talking with others who've experienced similar events or situations can be helpful. Support groups offer parents, families and caregivers a place to share concerns and find encouragement. Ask your health care provider if there are any support groups in your area.
If a baby has a large ventricular septal defect, it will likely be diagnosed soon after birth. Sometimes it's diagnosed before birth during a pregnancy ultrasound.
If you think your child has a VSD that wasn't recognized at birth, make an appointment with your child's health care provider. You may be referred to a heart doctor (cardiologist).
Here's some information to help you prepare for your appointment.
Write down the following and bring the notes with you to the appointment:
Ask a family member or friend to come with you to the appointment, if possible. Someone who goes with you can help remember what the care provider says.
Preparing a list of questions can help you and your health care provider make the most of your time together. Questions to ask the provider at the first appointment include:
Questions to ask if you are referred to a heart doctor (cardiologist) include:
Don't hesitate to ask other questions.
Your health care provider is likely to ask many questions, including:
If you are the person affected:
If your baby or child is affected: