Ventricular Septal Defect (VSD)
A congenital hole between the heart's two lower chambers
Quick Facts
- Type: Congenital heart defect
- Location: Wall between the two ventricles
- Often found: In infancy, by a heart murmur
- Many close: On their own without treatment
Overview
A ventricular septal defect is one of the most common heart defects present at birth. It is an opening in the muscular wall (the septum) that normally separates the two lower pumping chambers of the heart, called the ventricles. Because the left side of the heart pumps at higher pressure, blood flows through the hole from the left ventricle into the right ventricle and then back to the lungs.
Small defects often cause no problems and many close on their own during childhood. Larger defects send extra blood to the lungs and can make the heart work harder, sometimes requiring treatment. This is a congenital heart defect and is not caused by anything a parent did.
Symptoms
Small VSDs may cause no symptoms and are sometimes discovered only because a doctor hears a heart murmur. Larger defects usually cause symptoms in the first weeks or months of life:
- Fast or labored breathing and shortness of breath
- Tiring or sweating during feeding
- Poor weight gain or slow growth
- Frequent chest infections
- Pale skin and a fast heartbeat
A baby who is breathing very fast, struggling to feed, or turning dusky or blue needs urgent medical attention.
Causes
A VSD forms while the heart is developing during pregnancy, before birth. In most cases the exact reason the wall did not close completely is not known. Contributing factors can include:
- Genetic factors: VSDs can run in families and are more common in some genetic conditions, such as Down syndrome.
- Conditions during pregnancy: Certain infections, poorly controlled diabetes, alcohol use, and some medicines taken during pregnancy raise the risk.
Most defects happen by chance and are not the result of anything the parents could have prevented.
Risk Factors
- A family history of congenital heart defects
- Genetic conditions such as Down syndrome
- Poorly controlled diabetes during pregnancy
- Certain infections during pregnancy, such as rubella
- Alcohol or some medicines used during pregnancy
Diagnosis
Many VSDs are found when a doctor hears a characteristic heart murmur during a routine exam. Tests used to confirm and assess the defect include:
- Echocardiogram: An ultrasound of the heart that shows the hole, its size, and how blood is flowing. This is the main test.
- Electrocardiogram (ECG): Records the heart's electrical activity.
- Chest X-ray: Shows the size of the heart and blood flow to the lungs.
Some VSDs are now detected before birth on a prenatal ultrasound.
Treatment
Treatment depends on the size of the defect and the symptoms it causes.
- Watchful waiting: Many small VSDs close on their own, so the child is monitored with regular check-ups and echocardiograms.
- Medicines: Diuretics and other heart medicines can ease symptoms of a larger defect and help with feeding and growth while waiting for surgery or closure.
- Surgical repair: Open-heart surgery to patch the hole is used for large defects or ones causing significant symptoms.
- Catheter closure: Some defects can be closed with a device passed through a thin tube in a blood vessel, avoiding open surgery.
After successful repair, most children go on to live healthy, active lives.
Prevention
- Most VSDs cannot be prevented because they happen by chance
- Good control of diabetes before and during pregnancy lowers the risk of heart defects
- Avoid alcohol during pregnancy and review all medicines with a doctor
- Stay up to date on vaccinations, including rubella, before pregnancy
- Attend recommended prenatal care and ultrasound screening
When to See a Doctor
Contact a doctor if a baby tires easily during feeding, gains weight slowly, breathes fast, or has frequent chest infections. Seek emergency care if a child:
- Is breathing very rapidly or struggling to breathe
- Turns pale, gray, or blue, especially around the lips
- Becomes unusually sleepy, limp, or unresponsive
Frequently Asked Questions
Will a ventricular septal defect close on its own?
Many small VSDs close by themselves during infancy or early childhood as the heart grows. Larger defects are less likely to close and may need surgery or a catheter procedure. Regular echocardiograms track whether a hole is shrinking.
Is a VSD dangerous?
Small defects usually cause no harm, but a large VSD can overwork the heart and send too much blood to the lungs, leading to poor growth and heart strain if untreated. With timely treatment, the outlook is very good.
How is a VSD treated?
Small defects are simply monitored. Larger ones may be managed with heart medicines to ease symptoms and then closed with open-heart surgery or, in some cases, a device delivered through a catheter in a blood vessel.
Can a child with a VSD live a normal life?
Yes. After a small defect closes on its own or a larger one is repaired, most children grow up to be healthy and active. They usually have routine heart follow-up to confirm the heart is working well.
What are the warning signs in a baby with a VSD?
Fast or labored breathing, sweating and tiring during feeds, poor weight gain, and frequent chest infections are common signs of a larger defect. A baby who turns pale, gray, or blue or who is struggling to breathe needs emergency care.
References
- Centers for Disease Control and Prevention (CDC). Facts about Ventricular Septal Defect.
- Mayo Clinic. Ventricular septal defect (VSD) — Symptoms and causes.
- MedlinePlus, U.S. National Library of Medicine. Ventricular septal defect.