Reviewed by Brian R. Robinson, MDVSD is a congenital heart disorder. VSD is a hole in the wall (septum) between the left and right ventricles. This hole causes blood to flow between the ventricles, usually from left to right, overstraining the lungs and right ventricle. The condition is similar to an atrial septal defect, but VSDs are less likely than ASDs to close on their own.
The problem
In a healthy heart, blood passes from the left atrium to the left ventricle, which pumps it out of the heart to circulate throughout the body. After passing through all the organs, it enters the heart again in the right atrium. Then it passes to the right ventricle, which pumps it out to circulate through the lungs.
In a child with VSD, there is a hole in the wall between the right and left ventricle. This enables blood to flow between the ventricles. Because pressure is higher in the left side of the heart, blood usually flows from left to right. This leads to an excess of blood in the right side of the heart and in the lungs. This can cause symptoms of congestive heart failure, including fatigue, low appetite and low weight gain, and difficulty breathing. VSD usually has more intense symptoms than ASD, so treatment, with drugs or surgery, is more likely to be necessary.
Risks and complications
Mild VSDs may heal on their own, or they may remain but cause no complications. There are, however, complications can develop from having an otherwise unbothersome hole. If the hole remains unclosed, there is a small risk of developing endocarditis. This is a heart infection to which people with previous heart conditions are especially susceptible. It is often caused by bacteria introduced during dental procedures, so people with heart problems often take antibiotics before undergoing such procedures. This should not be necessary if the VSD has been surgically closed.
Children with unclosed VSDs are also susceptible to other infections, including the common cold. Mild illnesses can cause a baby with VSD to get sicker than he or she would otherwise.
Finally, since one of the symptoms is low appetite, care must be taken to provide the baby with proper nutrition, because the first years of life are some of the most formative. If the baby does not have proper nutrition during those years, he or she may not develop proper brain function.
Truncus arteriosus occurs when a vessel arises over a large ventricular septal defect. Surgery is usually required to close the defect and separate blood flow to the body and to the lungs.
Single-ventricle defects occur when one of the ventricles is underdeveloped. They include tricuspid valve atresia, hypoplastic left-heart syndrome, hypoplastic right-heart syndrome, mitral valve atresia, and double-inlet ventricle. Treatment includes limited competitive sports, occasional antibiotics to prevent endocardocarditis, and surgery. Sugery often involves shunts, placing a band on the pulmonary artery, or the Fontan Operation, which essentially separates the heart into two circulations. This procedure allows oxygen-poor blood to go to the heart and oxygen-rich blood go to the body.
A physician usually first detects mild cases of VSD during a routine physical examination. VSD produces a characteristic heart murmur that a doctor can detect with a stethoscope. A Chest
x-ray and echocardiogram are the next step, and in rare cases cardiac catheterization may be necessary.
Since the hole might close, the doctor may first want to monitor the baby for several months, giving him or her medication to alleviate any of the symptoms. Medications might include diuretics to drain some of the excess fluid, and medication to treat high blood pressure in the lungs. If the hole is too large to be properly treated with medication, open heart surgery to patch it may be necessary.
