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Ventricular Septal Defect

(VSD)

Definition

A ventricular septal defect (VSD) is a defect in the wall called the septum that is between the heart's two lower chambers called the ventricles. A septal defect is often referred to as a hole in the heart.
Normally, the right side of the heart receives oxygen-poor blood and pumps it to the lungs where it is filled with oxygen. The blood is then sent back to the left side of the heart, which pumps oxygen-rich blood to the rest of the body. But with VSD, the heart pumps inefficiently. The oxygen-rich blood is pumped back to the lungs.
VSD can lead to enlargement of the heart and high blood pressure in the blood vessels of the lungs.
Ventricular Septal Defect
Ventral septal defect
Copyright © Nucleus Medical Media, Inc.

Causes

Most VSDs are a type of congenital heart defect, meaning they are present at birth. It is unclear why VSDs develop, but genetics may play a part. Although rare, some VSDs can occur after a heart attack or trauma.

Risk Factors

Factors that increase your chances of VSD include:
  • Age: young infants and children
  • Parent with a septal defect
  • Genetic defects such as Down syndrome or other inherited disorders
  • Use of alcohol , phenylhydantoin, or isotretinoin
  • Rubella during the first trimester of pregnancy
  • Maternal diabetes or phenylketonuria

Symptoms

A small VSD may not cause symptoms Some VSDs may cause the following symptoms:
  • Heart murmur
  • Signs of heart failure during infancy
    • Difficulty feeding
    • Poor growth
    • Fast breathing

Diagnosis

Your doctor will ask about your child's symptoms and medical history. The exam will include listening to your child's heart to detect a heart murmur. If a heart problem is suspected, your child will likely be referred to a pediatric cardiologist. This is a doctor who specializes in heart problems in babies and children.
Your heart may need to be viewed. This can be done with:
Your heart activity may be tested. This can be done with electrocardiogram .
Your bodily fluids may need to be tested. This can be done with blood tests.
The oxygen in your blood may be tested. This can be done with pulse oximetry.
Cardiac Catheterization
Cardiac Catheterization
Copyright © Nucleus Medical Media, Inc.

Treatment

Talk with your doctor about the best treatment plan for you or your child. Treatment options include the following:

Watchful Waiting

More than half of VSDs will close on their own. If there are no signs of heart failure, your doctor may recommend periodic check-ups to see if the defect closes on its own.

Surgery

Surgery is often recommended to repair large VSDs that cause symptoms or that have not closed by one year of age. This involves open heart surgery to place a patch over the hole.

Extra Nutrition

In cases of VSD in which a child fails to gain weight, extra nutrition may be needed. This consists of high-calorie formulas, breast milk supplements, and tube-feedings.

Prevention

Since it is unclear what causes congenital VSDs, there is no known way to prevent them. Acquired VSDs may be prevented by early treatment of heart attacks.

RESOURCES

American Heart Association http://www.heart.org

National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov

CANADIAN RESOURCES

Canadian Cardiovascular Society http://www.ccs.ca

Heart and Stroke Foundation of Canada http://www.heartandstroke.com

References

Crenshaw BS, et al. Risk factors, angiographic patterns, and outcomes in patients with ventricular septal defect complicating acute myocardial infarction. Circulation. 2000;101;27-32.

What are holes in the heart? National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/dci/Diseases/holes/holes%5Fwhatare.html. Updated July 1, 2011. Accessed June 28, 2013.

Ventricular septal defect (VSD). EBSCO DynaMed website. Available at: http://dynamed101.ebscohost.com/Detail.aspx?id=116076. Updated June 14, 2012. Accessed June 28, 2013.

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