Ventricular septal defect (VSD)

Description

A ventricular septal defect (VSD) is a hole in the heart. It is a common problem of the heart that are present at birth (congenital heart defect). The hole in the wall that separates the heart's lower chambers (ventricles).

A ventricular septal defect (VSD) is changes in how blood flows through the heart and the lungs. The oxygen-rich blood is pumped to the lungs instead of out to the body. The oxygen-rich blood mixes with oxygen-poor blood. These changes may increase the blood pressure in the lungs and require the heart to work harder to pump blood.

A small ventricular septal defect may not cause any problem. Many of the small ventricular septal defects (Vsds) close on their own. Babies with medium or larger Vsds may need to have surgery early in life to prevent complications.

Symptoms

The symptoms of serious heart problems that are present from birth (congenital heart defects) often appear during the first few days, weeks or months of a child's life.

The symptoms of a ventricular septal defect (VSD) depend on the size of the hole and if there are other heart problems. A small VSD may never cause symptoms.

In general, VSD symptoms in the baby may include:

  • Good to eat
  • Little or no physical growth (delay)
  • Rapid breathing or shortness of breath
  • Easy tiring
  • Whooshing sound when listening to the heart with a stethoscope (heart murmur)

The symptoms of a ventricular septal defect in adults may include:

  • Shortness of breath, especially when exercising
  • Whooshing sound when listening to the heart with a stethoscope (heart murmur)

When to see a doctor

Call your health care provider if your baby:

  • You get tired easily when eating or playing
  • Is not gaining weight
  • It becomes out of breath when eating or crying
  • Fast breathing or shortness of breath

Call your doctor if these symptoms develop:

  • Shortness of breath
  • Rapid or irregular heartbeat
  • Fatigue or weakness

Causes

Ventricular septal defect (VSD) occurs when the baby's heart is developing during the pregnancy. The muscle wall that separates the heart into the left and right sides are not completely form, leaving one or more holes. The size of the hole or holes may vary.

There are often no clear cause. The genetic and environmental factors may play a role. Vsd can occur alone or with other problems with the heart present at birth. Rarely, a ventricular septal defect can occur later in life after a heart attack, or certain heart procedures.

How the heart works

To understand more about the ventricular septal defect (VSD), can be useful to know how the heart works normally.

The typical heart consists of four chambers: two upper chambers (atria) and two lower chambers (ventricles).

  • The right side of the heart moves the blood to the lungs.
  • In the lungs, the blood picks up oxygen.
  • The lungs pump oxygen-rich blood to the heart from the left side.
  • The left side of the heart pumps oxygen-rich blood to the rest of the body.

A ventricular septal defect changes the direction of blood flow in the heart and the lungs. The hole allows oxygen-rich blood to go back into the lungs instead of out to the body. The oxygen-rich blood and oxygen-poor blood is now mixed. If the ventricular septal defect is large, the pressure of the blood in the arteries of the lung may increase. Then the heart must work harder to pump blood. A large VSD may also increase the amount of blood flow in the arteries of the lung, causing congestion.

Risk factors

Risk factors for ventricular septal defects include:

  • Premature birth
  • Down syndrome and other genetic conditions
  • Family history of heart problems present from birth (congenital heart defects)

A baby born with ventricular septal defect can have other heart problems, such as:

  • Atrial septal defect
  • Coarctation of the aorta
  • Double outlet syndrome
  • Patent ductus arteriosus
  • Tetralogy of Fallot

If you already have a child with a congenital heart defect, a genetic counselor can discuss the risk that their next child to have one.

Complications

A small ventricular septal defect (VSD) can never cause problems. Some mid-size or large Vsd can be deadly. The treatment can help prevent many of the complications.

Complications of ventricular septal defect may include:

  • Heart failure. In a heart with a medium or large VSD , the heart works harder and the lungs have too much amount of blood pumped out to them. Without treatment, heart failure can develop.
  • The Eisenmenger syndrome. An unrepaired hole in the heart that can lead to this complication after many years. Irregular blood flow causes the blood vessels in the lungs become stiff and narrow. It raises the blood pressure in the pulmonary arteries (pulmonary hypertension). This syndrome permanently damages the blood vessels in the lungs.
  • Endocarditis. This is a rare complication of the IVC . An infection causes life-threatening inflammation of the inner lining of the heart chambers and valves.
  • Other heart problems. These include heart valve disease and irregular heart rhythms (arrhythmias).

Prevention

Because the cause is not clear, it may not be possible to prevent the ventricular septal defect (VSD). But to get good prenatal care is important. If you have a VIC, and is planning to become pregnant, schedule a visit with your doctor and follow these steps:

  • Get early prenatal care, even before you're pregnant. Talk with your doctor before you become pregnant about his health and talk about the lifestyle changes that your doctor may recommend for a healthy pregnancy. Also, make sure that you talk with your doctor about any medication you are taking.
  • Take a multivitamin with folic acid. Take 400 micrograms of folic acid daily has been shown to reduce birth defects in the brain and the spinal cord. You can help reduce the risk of congenital heart defects as well.
  • Avoid the consumption of alcohol. Drinking alcohol during pregnancy increases the risk of congenital heart defects.
  • Don ' t smoke or use illegal drugs. If you smoke, stop smoking. Smoking during pregnancy increases the risk of congenital heart defects in the baby. Avoid the use of illegal drugs, as they can cause harm to a baby.
  • Vaccination is recommended. Make sure you are up to date on all vaccines before you get pregnant. Some infections can be harmful to a developing fetus. For example, you have the rubella (German measles) during pregnancy can cause problems with a baby's heart development. A blood test before pregnancy can determine if you are immune to rubella. A vaccine is available for those who are not immune.
  • Keep your diabetes under control. A careful control of blood sugar before and during pregnancy can reduce the risk of congenital heart defects in the baby. Diabetes that develops during pregnancy (gestational diabetes) generally do not increase the risk of the baby. If you have diabetes, work with your doctor to make sure it is well controlled before you become pregnant.
  • Check with your doctor before taking any medicine. Some medicines may cause birth defects. Tell your doctor about all the medicines you are taking, including those bought without a prescription.

If you have a family history of heart problems present from birth, consider talking with a genetic counselor and a heart doctor (cardiologist) before you get pregnant.

Ventricular septal defect (VSD)

Diagnosis

Some ventricular septal defects (Vsd) was diagnosed soon after a child is born. However, ventricular septal defects (Vsd) may not be diagnosed until later in life. Sometimes a ventricular septal defect (VSD) that may be detected by an ultrasound of the pregnancy before the baby is born.

If the ventricular septal defect is present, your doctor may hear a sibilant sound (heart murmur) when listening to the heart with a stethoscope.

Tests that are done to help diagnose the ventricular septal defect include:

  • The echocardiogram. This is the most commonly used test for the diagnosis of a ventricular septal defect. Use sound waves to create images of the heart in motion. An echocardiogram can show how well the blood moves through the heart and the heart valves.
  • Electrocardiogram (ECG). This quick and painless test records the electrical activity of the heart. We can show you how fast or how slow the heart is beating.
  • X-ray of the chest. An x-ray of the chest shows the condition of the heart and the lungs. You can determine if the heart is enlarged and if the lungs of extra fluid.
  • Pulse oximetry. A sensor that is placed at the tip of the fingers of the records of the amount of oxygen in the blood. Very little oxygen can be a sign of a heart or lung problem.
  • The cardiac catheterization. In this test, a thin, flexible tube (catheter) that is inserted into a blood vessel in the groin or arm and guided through the blood vessels in the heart. Through cardiac catheterization, doctors can diagnose congenital heart defects and to determine the function of the heart valves and the chambers.
  • Cardiac magnetic resonance imaging (MRI). The magnetic fields and radio waves are used to create detailed pictures of the heart. A health care provider may order this test if you need more information after an echocardiogram.
  • Computed tomography (CT scan). A series of X-rays to create detailed pictures of the heart. It can be done if an echocardiogram does not provide as much information as needed.

Treatment

The Ventricular septal defect treatment may include regular health checkups, medications and surgery. Many babies born with a small ventricular septal defect (VSD) will not need surgery to close the hole. Some of the vsds close on their own.

If the VSD is small, regular medical checkups can be all you need. Medication can also be prescribed for the treatment of symptoms.

Infants with large ventricular septal defects, or that tire easily during feeding may need extra nutrition to help them grow. Some babies may need to take medications to help treat the symptoms of heart failure.

Drugs

Medications are not the repair of a ventricular septal defect, but can be given to treat the symptoms or complications. The specific medications that are used depend on the symptoms and its cause. Water pills (diuretics) is used to decrease the amount of fluid in the body and to reduce the strain on the heart.

Oxygen can be given.

Surgeries or other procedures

The surgery can be done if the VSD is medium or large, or if it is causing severe symptoms. Babies who need surgery to repair the hole often have the procedure in their first year.

A surgeon can close small ventricular septal defects if its location in the heart can cause damage to adjacent structures such as the heart valves.

Surgeries and procedures for the repair of a ventricular septal defect include:

  • Open-heart surgery. This is the preferred procedure for the repair of most of the defects of the ventricular septum. A surgeon uses a patch or stitches to close the hole between the lower chambers of the heart. This type of VSD surgery requires a heart-lung machine and an incision in the chest.
  • Catheter procedure. Some ventricular septal defects can be repaired using thin, flexible tubes (catheters) without the need for open-heart surgery. The doctor inserts a catheter into a blood vessel, usually in the groin, and the guide for the heart. A small device that is inserted through the catheter to close the hole.

After the ventricular septal defect surgery, regular checkups are necessary for life, ideally by a heart doctor (cardiologist). Medical check-ups often include imaging tests to determine how well the surgery is working.

Self-care

Lifestyle changes may be recommended to keep the heart healthy and prevent complications.

  • Prevent infections of the heart.Sometimes, the heart problems may increase the risk of infection in the lining of the heart or of the heart valves (endocarditis). Antibiotics may be recommended before dental procedures if you have low oxygen due to a largeVSD. The medications may also be recommended if you have a surgically repairedVSDwith a patch that still has the flow of blood through it. Antibiotics may also be recommended if you have recently had the catheter basedVSDrepair. To the majority of people with a ventricular septal defect, good oral hygiene, and regular dental checkups can prevent endocarditis.
  • Ask about the exercise of the restrictions. Many people with a ventricular septal defect can lead a healthy, active life without restrictions. But some may need to limit your exercise and sporting activities. Ask your health care provider that the sports and types of exercise are safe for you or your child. People with Eisenmenger syndrome should avoid strenuous physical activity.
  • Talk with your doctor before you become pregnant.If you have a ventricular septal defect and are pregnant or hoping to be, talk with your health care provider about the possible risks and complications. Together, you can discuss and plan any special care needed during pregnancy. A smallVSDor repaired without complications does not pose a major additional risk in pregnancy. However, a large unrepairedVSD, irregular heart rhythms, heart failure, or pulmonary hypertension may increase the risk of complications in pregnancy. Pregnancy is considered very high risk for those with Eisenmenger syndrome, and is not recommended.

Prevent infections of the heart. Sometimes, the heart problems may increase the risk of infection in the lining of the heart or of the heart valves (endocarditis). Antibiotics may be recommended before dental procedures if you have low oxygen due to a large VSD . The medications may also be recommended if you have a surgically repaired ventricular septal defect with a patch still has the flow of blood through it. Antibiotics may also be recommended if you have recently had a catheter-based VSD repair.

To the majority of people with a ventricular septal defect, good oral hygiene, and regular dental checkups can prevent endocarditis.

Talk with your doctor before you become pregnant. If you have a ventricular septal defect and are pregnant or hoping to be, talk with your health care provider about the possible risks and complications. Together, you can discuss and plan any special care needed during pregnancy.

A small VSD or repaired without complications does not pose a major additional risk in pregnancy. However, a large, unrepaired VSD , irregular heart rhythms, heart failure, or pulmonary hypertension may increase the risk of complications in pregnancy.

Pregnancy is considered very high risk for those with Eisenmenger syndrome, and is not recommended.

Coping and support

You may find that talking with others who have experienced similar events or situations that may be useful. Support groups provide parents, families and caregivers a place to share concerns and find encouragement. Ask your health care provider if there are support groups in your area.

Preparing for your appointment

If a baby has a large ventricular septal defect, is more likely to be diagnosed soon after birth. Sometimes it is diagnosed before birth during an ultrasound of the pregnancy.

If you think your child has a CIV that was not recognized at birth, make an appointment with your pediatrician. You may be referred to a heart doctor (cardiologist).

Here's some information to help you prepare for your appointment.

What you can do

Note the following, and bring the notes with you to the appointment:

  • Any of the symptoms, including any that may seem unrelated to heart problems.
  • When the onset of symptoms and the frequency with which they occur.
  • Important medical information, including a family history of heart problems present from birth.
  • All medicines, including those bought without a prescription. To include in the dose.
  • Questions for the health care professional.

Ask a family member or friend to go with you to the appointment, if possible. Someone who goes with you can help you remember what the doctor says.

Prepare a list of questions can help you and your health care provider that the majority of their time together. Questions for your provider in the first appointment are:

  • What is likely the cause of these symptoms?
  • There are other possible causes?
  • What tests are needed? Is any special preparation needed?
  • Should be consulted with a specialist?
  • Are there brochures or other printed material that I can take my house? What sites do you recommend?

Questions if you are referred to a heart doctor (cardiologist) include:

  • How big is the hole in the heart?
  • What is the risk of the complications of this condition?
  • How can we monitor for complications?
  • What treatment do you recommend it?
  • How often should we schedule the follow-up examinations and tests?
  • What is the long-term outlook for this condition?
  • Are there any activity restrictions?

Do not hesitate to ask other questions.

What to expect from your doctor

Your health care provider is likely to ask many questions, including:

If the affected person:

  • What are the symptoms?
  • When did the symptoms begin?
  • The symptoms worsened over time?
  • Are you aware of heart problems in your family?
  • Are being treated or have recently been treated for other health conditions?
  • You are planning to become pregnant?

If your baby or child is affected:

  • Does your child get tired easily, while eating or playing?
  • Is your child gain weight?
  • Does your child breathe quickly or run out of breath when eating or crying?
  • Has your child been diagnosed with other medical conditions?
Symptoms and treatment of ventricular septal defect (VSD)