Ventricular Septal Defect (VSD)

Causes of ventricular septal defects

A congenital heart defect is the most common cause of a ventricular septal defect. Some babies are born with a hole in their heart and may not know it is present until symptoms develop years later.

A ventricular septal defect can also be caused by severe trauma to the chest. Car accidents could provide enough force to cause a VSD.

Risk factors for a ventricular septal defect

Risk factors for developing a ventricular septal defect include:

• Being of Asian heritage
• Having a family history of congenital heart disease
• Having other genetic disorders such as Down syndrome
• Having other birth defects

Symptoms of ventricular septal defects

Symptoms of ventricular septal defects vary depending on the size of the hole and where it is located.

If the ventricular septal defect is small, the only symptom may be a loud heart murmur that is caused by blood flowing back into the right ventricle from the left ventricle.

If the hole is large, oxygen-rich blood will flow back into the right ventricle and mixes with oxygen-poor blood instead of feeding the oxygen needs in the body. The heart will try to pump harder to compensate and may enlarge. Pulmonary hypertension may develop in arteries of the lungs from the enlarged heart and high blood pressure.

Noticeable symptoms of a moderate to large ventricular septal defects include:

• Shortness of breath
• Fatigue
• Weakness

Diagnosis of a ventricular septal defect

Ventricular septal defects are typically diagnosed at birth or within a few days after birth. Doctors can hear a distinctive heart murmur when listening to the baby’s heart. If the VSD is not diagnosed at birth, you may experience shortness of breath or feel heart palpitations, and you need to be evaluated by a cardiologist.

Your physician may perform a variety of diagnostic tests including:

• Chest x-ray — takes a picture of your heart and lungs to see if the heart is enlarged or if there is fluid in the lungs.
• Electrocardiogram — measures the heart’s electrical activity to diagnose heart defects or rhythm problems.
• Transesophageal echocardiogram (TEE) — during a transesophageal echocardiogram, a thin tube is inserted into the esophagus and an image is taken as close to the heart as possible.
• Cardiac catheterization (cath) — can help diagnose congenital heart defects and diagnose any abnormalities in the heart valves or chambers.
• Cardiac MRI (magnetic resonance imaging) — takes images of the heart using radio and magnetic waves.

Treatment for ventricular septal defects

If you have a small VSD, you may not need immediate treatment. Your doctor may recommend close monitoring to determine if the defect corrects itself or needs more advanced treatment.

In patients where surgery is not immediately indicated, medications can temporarily manage the symptoms.

If the ventricular septal defect is causing severe symptoms, open-heart surgery may be required to prevent permanent damage to the arteries in the lungs.

Procedures that can be performed to repair a ventricular septal defect include:

• Ventricular surgical repair or patch — a patch made of pericardium, the normal lining of the heart, can be sewn over the ventricular septal defect to close it. In some cases, the defect can be sewn together without a patch.
• Ventricular endovascular repair or patch (catheterization) — repairing the hole by inserting a catheter into the blood vessel (through the groin) and closing the hole with a mesh device.