About ventricular septal defects
What is ventricular septal defects?
Ventricular septal defects are heart defects that are present at birth (congenital). The normal heart has four chambers. The two upper chambers, known as atria, are separated from each other by a fibrous partition known as the atrial septum. The two lower chambers are known as ventricles and are separated from each other by the ventricular septum. Valves connect the atria (left and right) to their respective ventricles. The aorta, the main vessel of arterial circulation, carries blood from the left ventricle and away from the heart.
Ventricular septal defects can occur in any portion of the ventricular septum. The size and location of the defect determine the severity of the symptoms. Small ventricular septal defects can close on their own; (spontaneously) or become less significant as the child matures and grows. Moderately-sized defects can cause congestive heart failure, which is characterized by an abnormally rapid rate of breathing (tachypnea), wheezing, unusually fast heartbeat (tachycardia), enlarged liver (hepatomegaly), and/or failure to thrive. Large ventricular septal defects can cause life-threatening complications during infancy. Persistent elevation of the pressure within the artery that carries blood away from the heart and to the lungs (pulmonary artery) can cause permanent damage to the lungs. The exact cause of ventricular septal defects is not fully understood.
What are the symptoms for ventricular septal defects?
Ventricular septal defect (VSD) symptoms in a baby may include:
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 at all. Signs and symptoms vary depending on the size of the hole and other associated heart defects.
Your doctor may first suspect a heart defect during a regular checkup if he or she hears a murmur while listening to your baby's heart with a stethoscope. Sometimes a VSD can be detected by ultrasound before the baby is born.
Sometimes a VSD isn't detected until a person reaches adulthood. Symptoms and signs can include Shortness of breath or a heart murmur your doctor hears when listening to your heart with a stethoscope.
What are the causes for ventricular septal defects?
Congenital heart defects arise from problems early in the heart's development, but there's often no clear cause. Genetics and environmental factors may play a role. VSDs can occur alone or with other congenital heart defects.
During fetal development, a ventricular septal defect occurs when the muscular wall separating the heart into left and right sides (septum) fails to form fully between the lower chambers of the heart (ventricles).
Normally, the right side of the heart pumps blood to the lungs to get oxygen; the left side pumps the oxygen-rich blood to the rest of the body. A VSD allows oxygenated blood to mix with deoxygenated blood, causing increased blood pressure and increased blood flow in the lung arteries. This results in increased work for the heart and lungs.
VSDs may be various sizes, and they can be present in several locations in the wall between the ventricles. There may be one or more VSD.
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 are the treatments for ventricular septal defects?
Many babies born with a small ventricular septal defect (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 on its own.
Babies who need surgical repair often have the procedure in their first year. Children and adults who have a medium or large ventricular septal defect or one that's causing significant symptoms may need surgery to close the defect.
Some smaller ventricular septal defects are closed surgically to prevent complications related to their locations, such as damage to heart valves. Many people with small VSDs have productive lives with few related problems.
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.
Medications for ventricular septal defect depend on the severity of heart failure symptoms. The goal of medication is to decrease the amount of fluid in circulation and in the lungs. Medications called diuretics, such as furosemide (Lasix), reduce how much blood must be pumped.
Surgeries or other procedures
Surgical treatment for ventricular septal defect involves plugging or patching the abnormal opening between the ventricles. If you or your child is having surgery to repair a ventricular defect, consider having surgery performed by surgeons and cardiologists with training and expertise in conducting these procedures.
Procedures to treat VSD may include:
- Surgical repair. This procedure of choice in most cases usually involves open-heart surgery under general anesthesia. The surgery requires a heart-lung machine and an incision in the chest. The doctor uses a patch or stitches to close the hole.
- Catheter procedure. Closing a ventricular septal defect during 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 specially sized mesh device to close the hole.
After repair, your doctor will schedule regular medical follow-up to ensure that the ventricular septal defect remains closed and to look for signs of complications. Depending on the size of the defect and the presence of other problems, your doctor will tell you how frequently you or your child will need to be seen.
What are the risk factors for ventricular septal defects?
Ventricular septal defects 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.
Is there a cure/medications for ventricular septal defects?
Ventricular septal defects (VSDs) are congenital heart defects that occur when there is a hole in the dividing wall between the right and left ventricles. They are most common in people with Down syndrome and Turner syndrome, but they can also be found in other conditions. They're sometimes called "holes in the heart."
Most babies with VSDs will not experience any symptoms and will not need treatment. However, if you have a VSD and experience symptoms such as rapid breathing or a fast heartbeat, it's important to see your doctor right away.
- If your doctor recommends surgery to close a VSD, your surgeon will usually make a small cut between your ribs to reach the heart. Then, he or she will use special tools to close the hole in the wall between your ventricles.
- There isn't a cure for ventricular septal defects, but there are treatments to help manage them. Depending on the severity of the defect, your doctor might recommend surgery to close it or medications to help prevent complications.
- Medications: Doctors usually prescribe beta-blockers and ACE inhibitors to help with blood pressure control. These drugs can also help with symptoms associated with a VSD.
- Surgery: Some patients may need surgery as well as medication. This surgery can close off the defect so that there is no more mixing of oxygenated and deoxygenated blood.
Wheezing, especially with exercise,Shortness of breath,Chest pain when you breathe in (on inhalation) or out (on exhalation),Bluish color to lips, nail beds, and skin (cyanosis),Fast breathing (tachypnea) or fast heartbeat (tachycardia)
Heart attack,High blood pressure,Valve defects,Infection