A ventral septal defect, more commonly known as a ventricular septal defect (VSD), is a hole between the heart’s lower chambers (ventricles). The defect can occur anywhere within the muscle dividing the two sides of the heart.
There are varying types of VSD defects. Smaller defects may close without any treatment, and will not cause any long-term effects. Defects that don’t close on their own can usually be repaired by surgery.
According to the National Institutes of Health, VSD is one of the most common congenital birth defects (NIH, 2011).
The most common cause of a VSD is a congenital heart defect (defect from birth). Certain people are born with hole(s) already present. They may cause no symptoms and take years to diagnose.
A rare cause of VSD is severe blunt trauma to the chest. Serious car accidents with direct, forceful or repeated trauma to the chest may be sufficient to cause a VSD.
VSDs often occur at the same time as other birth defects, and many of the same factors that increase the risk for other birth defects increase the risk of a VSD.
In addition, some specific risk factors for VSD include:
- being of Asian heritage (Asians are more likely to be born with VSD)
- a family history of congenital heart disease
- VSD is also common with other genetic disorders, such as Down syndrome.
In some children, VSD causes no real symptoms. If the hole in the heart is quite small, there may be no signs of the problem.
If symptoms are present, the will typically include:
- difficulty breathing
- rapid breathing
- pale skin coloration
- frequent respiratory infections
- bluish color to the skin, especially around the lips and fingernails
In addition, it is often difficult for babies with a VSD to gain weight and they may experience profuse sweating during feeding. All of these symptoms can be very dangerous. If your baby or child develops any these symptoms, contact your doctor immediately.
In order for your doctor to diagnose a VSD, he or she will listen to your baby’s heart through a stethoscope, take a complete medical history, and will probably need to have several types of tests performed. These tests include:
Transesophageal Echocardiogram (TEE):
This is an ultrasound picture taken by first numbing the throat, then sliding the ultrasound device on a thin tube down the throat and into the esophagus, so it is close to the heart,
Echocardiogram With Agitated Saline Bubble Test
This is an ultrasound taken of the heart while saline bubbles are given by injection into the bloodstream.
Magnetic Resonance Imaging (MRI)
This test uses radio and magnetic waves to take images of the heart.
Treatment may require surgery to repair the damage. If the VSD is small and not causing any symptoms, then surgery may not be necessary. In this case, your doctor will recommend a “wait and watch” approach. Whatever the decision, your doctor will carefully monitor you or your baby’s health to make certain either the surgery corrected the problem, or it is correcting itself.
If the VSD in your baby’s heart is large, medication may be needed to control the symptoms before surgery. Medication may include digoxin (a drug made from the foxglove plant Digitalis lanata) and/or diuretics.
The outlook of VSD depends upon the type of defect. In babies with small defects and/or no symptoms, a VSD may close without the need for any intervention. Generally, these babies will be closely watched by your doctor to make sure symptoms don’t develop or to monitor the progress of the VSD closure.
The timing of the recovery from surgery will often depend on the size of the defect and whether there were any other health problems or heart problems. According to the Mayo Clinic, VSD surgery has excellent long-term outcomes (Mayo).