What Is Ventricular Septal Defect?
Ventricular septal defect (VSD) is a birth defect in babies that causes a hole in the wall (or septum) between a baby’s lower heart chambers. Heart chambers are also called right and left ventricles. VSD is congenital, which means babies are born with this condition.
If your baby has VSD, red blood (oxygen-rich blood) can freely mix with oxygen-poor blood (or blue blood). Red blood is able to flow into the left ventricle through the hole in your baby’s septum.
Babies are born with different types of ventricular septal defects. Some babies are born with holes in different areas of their septum (or heart wall). Where your baby’s hole is located determines the type of VSD your baby has. Babies can also have different sized holes in their septum.
If your baby has a hole in the wall that separates the upper two chambers of the heart, she has an atrial septal defect.
How Common Is VSD in Babies?
VSD is the most common congenital heart defect in babies. One in 500 babies is born with VSD.
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Causes & Symptoms
What Causes VSD?
Doctors know that mutations (or differences) in a baby’s genes cause VSD. But doctors don’t know what causes these genes to mutate in the first place. Some families may have more babies who are born with VSD.
Symptoms
How severe VSD symptoms are depends on a few things. These include:
- How old your baby is when she first begins showing symptoms, and
- and how large the hole or opening is inside your baby’s septum.
More blood will pass between the heart’s chambers if the hole is larger. This means your child’s lungs and right ventricles will have to work harder to help your child breathe.
Some babies have VSD symptoms as soon as they’re born. Other children don’t show VSD symptoms until they’re a little older. Symptoms can be different in every child. Symptoms of VSD may include the following:
- fast breathing
- tiredness
- difficulty breathing
- pale skin
- fast heart rate
- a liver that’s larger than normal
- trouble feeding or being tired while feeding
- trouble gaining weight
VSD shares symptoms with many other diseases. Because of this, many parents mistake VSD symptoms as a sign of other diseases. Make sure you take your child to a doctor so you can get a correct diagnosis.
Can a VSD Close on Its Own?
Small holes in your child’s septum may close on their own as your child gets older. Some small holes will never close on their own, but your child may not need treatment for these small holes.
Children with larger VSDs usually need surgery or cardiac catheterization to close these holes.
After your baby is diagnosed with VSD, your baby’s doctor will regularly check the hole inside the septum and watch if the hole is closing on its own.
How is Ventricular Septal Defect Diagnosed?
The first sign of VSD is usually a strange, abnormal sound (heart murmur) when a doctor listens to your child’s heartbeat through a stethoscope. If your doctor hears a heart murmur, she may refer your child to a special heart doctor for children called a pediatric cardiologist.
Your heart doctor will listen to your baby’s heart and lungs. She will also pay close attention to your baby’s heart murmur to make a diagnosis.
Some doctors do extra tests to be sure your child has VSD. Different doctors prefer different types of tests. Your doctor will also think about your child’s age and condition when choosing a test.
Chest X-Ray
Chest X-rays show pictures of your child’s heart and lungs. Doctors sometimes use chest X-rays to spot VSD. This is because an X-ray can show if your child’s heart is larger than normal (an enlarged heart). Some children with VSD have larger hearts because their left ventricles fill with more blood than usual.
Heavier blood flow can also cause changes in your child’s lungs. Chest X-rays can also spot these changes.
Electrocardiogram
An electrocardiogram (or ECG) shows electrical activity inside your baby’s heart. ECGs can also find abnormal heartbeats (called arrhythmias) and can also see if your baby’s heart muscle is stressed.
Echocardiogram (Echo)
An echocardiogram (or echo) uses sound waves to show a picture of your baby’s heart and heart valves while they’re moving. Echo tests can diagnose VSDs because they show how much blood flows through the hole in your child’s septum.
Treatment
Doctors will look at your baby’s age, symptoms, and overall health to choose the best treatment. Your baby’s doctor will also consider how severe the VSD is.
Medicine
Some babies with VSD can take medicine so their heart and lungs can work more normally. Your baby may never need medication if she doesn’t have any symptoms.
Good Nutrition
Babies who have larger holes inside their septum may get tired when they try to eat. Because feeding is so tiring, these babies may not gain enough weight. If your baby isn’t gaining enough weight, she may need:
- Breastmilk or a formula with lots of calories. Your baby may need to drink milk that has extra calories added to it. Parents can buy nutritional supplements and add these to formula or pumped breastmilk.
- Feedings through a tube. Some parents will need to feed their babies using a small, flexible tube. This tube will run down your baby’s nose, esophagus, and finally into their stomach. For some babies, tube feeding should completely replace bottle feeding. Other babies can do both tube and bottle feedings.
If your baby is strong enough to drink part of her bottle on her own, you can use a feeding tube to finish her feeding. But some babies are too weak to bottle feed at all. These babies will need to get all their food through a feeding tube.
Surgery
Your doctor may recommend surgery so she can close your child’s hole before it causes lung damage. Surgery can also help babies have feeding problems and have trouble gaining weight.
During surgery, your child’s doctor will use stitches or a patch to close the hole inside the septum. Your doctor may use an echocardiogram or cardiac catheterization to decide when it’s best for your child to have surgery. You can talk to your doctor to learn more about surgery.
Cardiac Catheterization
One way to close a VSD hole is to use cardiac catheterization. In this procedure, doctors use a small, flexible tube called a catheter plus another tool called a septal occluder. Your child’s doctor will carefully push the catheter through your baby’s blood vessels all the way into your child’s heart. Then, your doctor will use the septal occluder to close up the hole in your baby’s heart.
Cardiac catheterization procedures are safe.
What Happens to Children With VSD?
Over time, ventricular septal defects can cause health problems for your baby if she doesn’t get treatment. Potential problems may include the following:
- Heart failure
- Lung problems
- Irregular heartbeats (also called arrhythmias)
- Problems in the heart’s valves
- Weak growth and development
Small VSDs
Many babies who have small VSDs have no symptoms. Your baby might not need medicine if the hole inside her heart is small. It will still be important for your baby to get regular check-ups so your doctor can monitor the hole.
If the hole inside your baby’s heart is going to close on its own, it will usually happen by the time she’s 2 years old. But some VSDs don’t close until a child turns 4. Children with small VSDs usually have healthy, normal lives. They can do everything that other children can do.
Medium to Larger-Sized VSDs
Your doctor will closely monitor your baby if she has a larger VSD (moderate to severe VSD). The doctor will decide when and what treatment is best. If your baby needs surgery, she will be admitted to the hospital. Before surgery, you may need to give your baby medicine and feed her in special ways to prepare. Your child’s doctors will teach you how to care for your baby at home.
After your child leaves the hospital, your doctor may give her antibiotics so she won’t get an infection after leaving the hospital.
If it was hard for your baby to eat before she had surgery, she’ll probably have more energy as soon as the surgery is over. Babies quickly start to eat better and gain weight after surgery.
Your child should be completely better within just a few weeks after surgery. She should be able to get back to her day-to-day activities. Older children usually have enough energy to do the things they love soon after surgery.
Most children who have VSD surgery grow up to be healthy and normal. After surgery, your child’s energy level, appetite, and growth will probably be normal, just like other children’s.
It’s important to ask your doctor about the long-term outlook for your child. Outcomes are usually excellent when VSD is diagnosed early. Outcomes are worse for children who are diagnosed with VSD when they’re older. This is because older children may have complications after surgery. It’s also harder for doctors to fix VSD in older children.
Some VSDs can cause long-term health problems like lung problems or heart failure. If your child has a higher chance of developing these problems, be sure to get follow-up treatment at a hospital that specializes in congenital heart disease.
Important Points About Ventricular Septal Defects
- A ventricular septal defect (or VSD) is a hole or opening in the septum. The septum is the wall that divides the lower two chambers inside your baby’s heart.
- How big the hole is will affect how bad your child’s symptoms are.
- Some small VSDs close on their own as your child gets older. If the hole inside your child’s heart is large, she’ll probably need surgery or cardiac catheterization to close it.
- Most children with VSD have normal, healthy lives as long as they get treatment. Your child’s hole may close on its own. If it doesn’t, your child will probably need treatment.
When Should I Call My Child's Doctor?
You should call your child’s doctor if it’s hard for your baby to breathe or eat. You should also call a doctor if your baby shows signs of any new symptoms.
Next Steps
Finding out that your child has a ventricular septal defect can be confusing and overwhelming. Before you visit a doctor to talk about your child’s condition, keep these tips in mind:
- Before your appointment, write down any questions you’d like your doctor to answer.
- Know why you’re making the appointment and what you want to gain from the appointment.
- After your child’s appointment is over, write down the names any new diagnoses the doctor gave your child. Also, write down the names of any new medications, tests, or treatments the doctor recommends.
- If your doctor is prescribing a new medicine or treatment, know why. How will this medicine or treatment help your child? Be sure you know if the medicine has any side effects.
- Ask if your child can get other types of treatment for VSD.
- If your doctor is recommending a special test or procedure, know why. Be sure to learn about what the test results will tell you.
- Know what could happen if your child doesn’t take medicine or get the test or procedure your doctor is recommending.
- If your child will have a follow-up appointment, be sure to write down when and where the appointment will be. Write down the reason your child needs that follow-up appointment.
- Know how to contact your doctor’s office after business hours. It’ll be important to contact your child’s doctor after hours if your child gets sick and you have questions or need help.