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Ventricular Septal Defect

What is a ventricular septal defect?

A ventricular septal defect (VSD) is an abnormal opening between the left and right lower heart chambers (ventricles). The opening is in the wall (septum) between the two ventricles. This opening allows oxygen-rich blood from the heart's left ventricle to flow into the right ventricle. Then it is pumped back to the lungs, even though this blood does not need oxygen. The heart must work harder to pump more blood to the body. Septal defects vary in size and in the symptoms they produce.

How does it occur?

A VSD is the most common birth defect of the heart. Often it is the only defect, but sometimes there are other heart defects as well. Most of the time the cause of the birth defect is not known.

Rarely, an injury to the heart may cause a VSD.

What are the symptoms?

A small VSD usually causes no symptoms. The only sign of the birth defect is a heart murmur, which is a sound your healthcare provider can hear with a stethoscope.

Even if the defect is large, a baby often does not have symptoms until several weeks after birth. Some babies with a large VSD do not grow normally and may become undernourished because they do not feed well. Other symptoms include sweating, increased breathing rate, and frequent lung infections. A large VSD in small children can lead to severe heart failure. This means that the heart cannot do its proper job as a pump.

How is it diagnosed?

A healthcare provider is usually able to hear the heart murmur of a VSD with a stethoscope. A chest X-ray may show that the heart is slightly larger than normal and that there is more blood flow through the lungs.

An ultrasound test called an echocardiogram uses sound waves to make pictures of the heart. Doppler ultrasound, a special type of echocardiogram, outlines flowing blood, shows the location of the VSD, and can help your healthcare provider know how big the VSD is. The echocardiogram also indicates whether there is increased blood pressure in the lungs.

A test called cardiac catheterization may be used to confirm the diagnosis and to be sure there are no other heart problems. Cardiac catheterization is a procedure in which a thin tube is passed through a blood vessel and into the heart to check the heart. It can also be used to repair the heart.

How is it treated?

A small VSD usually does not cause any problems and seldom requires treatment. Small VSDs may close on their own during the first years of childhood. The smaller the defect, the greater the chance that it will close on its own. People with a small VSD may lead normal lives.

Medium and large ventricular septal defects may need to be fixed with surgery. The VSD is closed by sewing a patch of a special material (Dacron) over the defect. The patch may be placed with heart catheterization or surgery. The surgery helps prevent problems later in life, including heart failure and high blood pressure in the lung arteries.

When surgical repair of a VSD is not an emergency, the operation carries very little risk.

How long will the effects last?

Often if the VSD is small, it will close on its own. If a larger VSD is not repaired, a child may have difficulty growing. He or she may have signs and symptoms of heart failure--for example, breathing problems.

Children who have surgery to repair a VSD before they are 2 years old usually do well. Older children and young adults who have surgical repair may still have some problems with how their heart works. These problems, which include abnormal heart rhythms and a slightly reduced pumping ability of the heart, are usually not serious and may be treated with medicine.

Written by Donald L. Warkentin, MD, and Reginald L. Washington, MD, FAAP, FAAC.
Published by RelayHealth.
Last modified: 2011-02-04
Last reviewed: 2009-04-28

This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a health care professional.

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