Ventricular Septal Defect
Ventricular septal defects (VSDs) are a congenital heart defect that is characterized by a hole in the ventricular septum, the wall that divides the two ventricles (lower chambers) in the heart. This defect allows oxygen-rich blood in the left ventricle to mix with the oxygen-poor blood in the right ventricle.
About a Ventricular Septal Defect
A ventricular septal defect (VSD) causes extra blood flow to the lungs and higher pressure in the blood vessels in the lungs. A small ventricular septal defect may not cause any problems or symptoms and may close on its own. A large ventricular septal defect can seriously affect how the heart functions and could lead to congestive heart failure. Without treatment, children who have a large VSD may develop dilation of pulmonary arteries or lung disease. Treatment options are available and can be effective and allow your child to have an active life.
What causes a VSD isn’t clear, but the defect develops as the heart forms in early pregnancy. Your baby’s risk for VSD may be higher if there is a family history of heart defects. A VSD can occur in conjunction with other heart defects, such as tetralogy of Fallot and transposition of the great arteries.
Symptoms of a Ventricular Septal Defect
A child born with a VSD may have symptoms while still in infancy. Symptoms vary depending on the severity of the VSD.
Common symptoms of a VSD may include:
- Poor weight gain or growth
- Rapid heart rate
- Rapid, heavy, or congested breathing
- Trouble feeding
Diagnosing a Ventricular Septal Defect
Your obstetrician may detect a VSD during an ultrasound while your baby is still developing in utero. After birth, your baby’s doctor may hear a heart murmur, which are extra sounds heard throughout the cardiac cycle due to increased blood flow. If your obstetrician suspects increased blood flow, a recommendation to see a pediatric cardiologist may be made.
Tests performed when diagnosing a VSD may include:
- Cardiac Catheterization: During cardiac catheterization, a small catheter (thin tube) is inserted into a larger blood vessel, typically in the groin, and guided to the heart where blood pressure and oxygen measurements can be taken in the aorta and pulmonary artery as well as the four chambers of the heart. A dye can also be injected through the tube to make the heart’s structure more visible on an X-ray.
- Chest X-Ray: A chest X-ray produces an image of the tissue and bones in the heart and lungs and helps your provider assess the shape, size, and structure of the heart and lungs as well as the aeration of or any congestion in the lungs. An enlarged heart or changes to the lungs caused by a VSD can be observed on an X-ray.
- Electrocardiogram (ECG or EKG): An electrocardiogram uses electrodes that are placed on the body to record the electrical activity taking place in the heart. An ECG/EKG test helps detect abnormal rhythms, such as cardiac arrhythmias, stress on the heart, and damage to the heart muscles.
- Echocardiogram: An echocardiogram uses ultrasound technology to create a moving image of the heart and its valves, allowing your provider to assess the structure and function of the heart. An echocardiogram also helps provide information about blood flow and how well the heart is pumping blood.
- Pulse Oximetry: A pulse oximeter, or oxygen saturation test, is an electronic tool used to measure oxygen in the bloodstream.
Treating Ventricular Septal Defect
Small VSDs may close on their own without treatment.
Treatment options for larger ventricular septal defects may include:
- Cardiac Catheterization: Using the same method as for diagnosis, a small tube can be inserted through a blood vessel in the groin and guided to the heart to plug the hole.
- Medication: Digoxin can be prescribed to strengthen the heart’s contractions and maintain a regular heartbeat, a diuretic can be prescribed to alleviate fluid retention in the lungs and body, or an angiotensin-converting enzyme (ACE) inhibitor can be prescribed to lower blood pressure. Beta-blockers may also be used to regulate your child’s heartbeat.
- Surgery: A VSD can be patched or plugged during surgery. This may happen via cardiac catheterization, open-heart surgery, or a hybrid procedure using both techniques.
After repairing the defect, your pediatric cardiologist may recommend that your child take antibiotics for a while to prevent infective endocarditis. Once they recover from treatment, most children are able to be active without any restrictions. Your child may need periodic check-ups with a pediatric cardiologist to make sure their heart is functioning well.
Care Team Approach
The Texas Center for Pediatric and Congenital Heart Disease, a clinical partnership between Dell Children’s Medical Center and UT Health Austin, takes a multidisciplinary approach to your child’s care. This means your child and your family will benefit from the expertise of multiple specialists across a variety of disciplines. Your care team will include pediatric cardiologists, cardiothoracic surgeons, interventional cardiologists, critical care specialists, hospitalists, anesthesiologists, perfusionists, nurses, advanced practice providers, social workers, psychologists, child life specialists, dietitians, physical and occupational therapists, pharmacists, and more, who work together to provide unparalleled care for patients every step of the way. We collaborate with our colleagues at the Dell Medical School and The University of Texas at Austin to utilize the latest research, diagnostic, and treatment techniques, allowing us to identify new therapies to improve treatment outcomes. We are committed to communicating and coordinating your child’s care with referring physicians and other partners in the community to ensure that we are providing comprehensive, whole-person care.