Ventricular septal defect or VSD is a congenital heart defect that needs to be treated immediately. This condition causes the heart to have a hole in the wall (septum) that separates the two lower chambers (ventricles) of the heart.
This condition can occur in almost half of all children with congenital heart disease. It can also occur on its own or with other congenital diseases. If not treated immediately, the overall growth and development of the little one.
The following is an explanation of the definition, symptoms, causes, and how to treat it.
What is Ventricular Septal Defect (VSD)?
VSD occurs during pregnancy when the wall that forms between the two ventricles does not fully develop, eventually leaving a hole. This disease is one type of congenital heart defect, meaning it is present from birth.
In babies without congenital heart defects, the right side of the heart pumps oxygen-poor blood from the heart to the lungs, and the left side of the heart pumps oxygen-rich blood to the rest of the body.
In babies with a VSD, blood often flows from the left ventricle through the ventricular septal defect into the right ventricle and into the lungs. This extra blood pumped into the lungs forces the heart and lungs to work harder.
Over time, if not repaired, this defect can increase the risk of other complications, including heart failure, high blood pressure in the lungs (called pulmonary hypertension ), irregular heart rhythms (called arrhythmias), or even stroke.
Types of Ventricular Septal Defect (VSD)
Babies with a ventricular septal defect may have one or more holes in different places on the septum. There are several names for these holes. Some common locations and names are:
1. Conoventricular Ventricular Septal Defect
In general, this is the hole where parts of the ventricular septum should meet just below the pulmonary and aortic valves.
2. Perimembranous Ventricular Septal Defect
This is a hole in the upper part of the ventricular septum.
3. Ventricular Septal Defect
This is a hole in the septum near where blood enters the ventricles through the tricuspid and mitral valves. This type of ventricular septal defect may also be part of another heart defect called an atrioventricular septal defect (AVSD).
4. Muscular Ventricular Septal Defect
This is a hole in the lower, muscular part of the ventricular septum and is the most common type of ventricular septal defect.
Symptom
Babies with a VSD may have no symptoms. However, if the hole is large, babies often have symptoms related to heart failure.
The most common symptoms include:
- Hard to breathe
- Rapid breathing
- Difficulty breathing
- Paleness
- Failure to gain weight
- Rapid heartbeat
- Sweating while breastfeeding
- Frequent respiratory tract infections
This cross-sectional diagram of the heart shows a ventricular septal defect (VSD) — some blood flows normally from the left atrium to the left ventricle, then to the aorta. But a hole in the septum (VSD) also allows blood to flow directly from the left ventricle to the right ventricle.
Older children or teens who have a small VSD that doesn’t close usually have no symptoms other than a heart murmur. They may need to see their doctor regularly to make sure the VSD isn’t causing problems.
These signs usually indicate that the VSD will not close on its own, and the child may need heart surgery. This is usually done in the first 3 months of a baby’s life to prevent other problems. A cardiologist can prescribe medication to reduce symptoms before the baby has surgery.
Reason
Congenital heart defects arise from problems early in the heart’s development, but often there is no clear cause. Genetics and environmental factors may play a role. VSDs can occur on their own or with other congenital heart defects.
During fetal development, a ventricular septal defect occurs when the muscular wall that separates the heart into left and right sides (the septum) fails to form completely between the lower chambers of the heart (the ventricles).
Normally, the right side of the heart pumps blood to the lungs for oxygen; the left side pumps oxygen-rich blood to the rest of the body.
VSD allows oxygenated blood to mix with deoxygenated blood, causing increased blood pressure and increased blood flow in the pulmonary arteries. This causes increased work for the heart and lungs.
It is also possible to get a VSD later in life, usually after a heart attack or as a complication after certain heart procedures.
In some cases, a tendency to develop VSDs may be due to a genetic syndrome that causes extra or missing pieces of chromosomes. However, most VSDs have no obvious cause.
Frequency of Occurrence
VSDs occur in about one-third to 1% of all newborns. However, the diagnosis of VSD in adults is much less likely because the defect closes on its own during childhood in 90% of cases.
VSD as a side effect of a heart attack is very rare, especially because of modern heart attack treatment methods. Currently, it occurs in less than 1% of all heart attacks.
Risk Factors
Ventricular septal defects can run in families and can sometimes occur because of 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.
Diagnosis
Doctors usually find a VSD in the first few weeks of a baby’s life during a routine exam. They’ll hear a heart murmur, which has certain characteristics that tell them it’s caused by a VSD.
If your child has a heart murmur, your doctor may refer you to a pediatric cardiologist (a doctor who diagnoses and treats childhood heart conditions).
A cardiologist will perform an exam and take your child’s medical history. If the doctor thinks there is a VSD, they may order tests such as:
- Echocardiogram. In this test, sound waves produce video images of the heart. Doctors can use this test to diagnose a ventricular septal defect and determine its size, location, and severity. It can also be used to see if there are other heart problems. Echocardiography can be used on a fetus (fetal echocardiography).
- Electrocardiogram (ECG). This test records the electrical activity of the heart through electrodes attached to the skin and helps diagnose heart abnormalities or rhythm problems.
- Chest X-ray . X-ray images help your doctor look at your heart and lungs to see if they are enlarged and if your lungs have extra fluid.
- Cardiac catheterization. In this test, a thin, flexible tube (catheter) is inserted into a blood vessel in the groin or arm and guided through the blood vessels to the heart. Through cardiac catheterization, doctors can diagnose congenital heart defects and determine the function of the heart’s valves and chambers.
- Pulse oximetry. A small clip on the fingertip measures the amount of oxygen in the blood.
Handling
Many babies born with a VSD do not require surgery to close the opening. After birth, the doctor may want to observe the baby and treat symptoms while waiting to see if the defect closes on its own.
Babies who need surgery often undergo the procedure in their first year. Children and adults who have a medium or large ventricular septal defect or one that causes significant symptoms may need surgery to close the defect.
Some smaller ventricular septal defects are surgically closed to prevent complications related to their location, such as damage to the heart valves. Many people with small VSDs have productive lives with few related problems.
Babies who have a large VSD or who tire easily during feedings may need extra nutrition to help them grow. Some babies may need medication to help treat heart failure.
Drugs
Treatment for ventricular septal defect depends on the severity of heart failure symptoms. The goal of treatment is to reduce the amount of fluid circulating and in the lungs. Medicines called diuretics, such as furosemide (Lasix), reduce how much blood the heart has to pump.
Operation or Other Procedure
Surgical treatment for ventricular septal defects involves blocking or patching the abnormal opening between the ventricles. If you or your child are having surgery to repair a ventricular defect, consider having the surgery performed by a surgeon and cardiologist with training and expertise in performing these procedures.
Procedures to treat VSD may include:
- Surgical repair. This elective procedure 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 does not require opening the chest. Instead, 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 instrument to close the hole.
After repair, your doctor will schedule regular medical follow-ups to make sure 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 often your child will need to be seen.
Possible Complications
Small ventricular septal defects may never cause problems. Medium or large defects can cause a range of disabilities — from mild to life-threatening. Treatment can prevent many complications.
Complications may include:
1. Heart failure
In a heart with a medium or large VSD, the heart works harder and the lungs have too much blood pumped to the heart. Without treatment, heart failure can develop.
2. Pulmonary hypertension
Increased blood flow to the lungs due to a VSD causes high blood pressure in the pulmonary arteries (pulmonary hypertension), which can permanently damage them. This complication can lead to a reversal of blood flow through the hole (Eisenmenger syndrome).
3. Endocarditis
This heart infection is a rare complication.
Other heart problems. These include abnormal heart rhythms and valve problems.
Prevention
In most cases, there is nothing that parents can do to prevent their baby from having a ventricular septal defect. However, it is important to do everything possible to have a healthy pregnancy. Here are some things to consider when pregnant:
1. Do a self-examination before getting pregnant
Talk to your doctor before you get pregnant about your health and discuss any lifestyle changes your doctor may recommend for a healthy pregnancy. Also, be sure to talk to your doctor about any medications you are taking.
2. Eat a balanced diet
Include a vitamin supplement containing folic acid.
3. Exercise Regularly
Work with your doctor to develop an exercise plan that’s right for you.
4. Avoid Risks
This includes harmful substances such as alcohol, tobacco and illegal drugs.
5. Avoid Infection
Make sure you are up to date on all vaccinations before becoming pregnant. Certain types of infections can be harmful to a developing fetus.
6. Keep Diabetes Under Control
If you have diabetes, consult your doctor to make sure it is well controlled before becoming pregnant.
If you have a family history of heart disease or other genetic disorders, consider talking to a genetic counselor before getting pregnant.
That’s the information about ventricular septal defect. Hopefully it is useful for Parents !
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