What Is a Ventricular Septal Defect (VSD)?

A ventral septal defect, more commonly known as a ventricular septal defect (VSD), is a hole between your heart’s lower chambers, or ventricles. The defect can occur anywhere in the muscle that divides the two sides of the heart.

There are varying types of VSDs. 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, VSDs are one of the most common congenital birth defects.

In some children, VSDs don’t cause any symptoms. If the hole in their heart is small, there may be no signs of the problem.

If symptoms are present, they typically include:

  • difficulty breathing
  • rapid breathing
  • pale skin coloration
  • frequent respiratory infections
  • a bluish skin color, especially around the lips and fingernails

It’s also 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 and if your baby or child develops any of these symptoms, contact your doctor immediately.

The most common cause of a VSD is a congenital heart defect, which is a defect from birth. Some people are born with holes already present in their heart. They may cause no symptoms and take years to diagnose.

A rare cause of a VSD is severe blunt trauma to the chest. For example, a serious car accident with direct, forceful, or repeated trauma to the chest may cause a VSD.

VSDs often occur at the same time as other birth defects. Many of the same factors that increase the risk for other birth defects also increase the risk of a VSD.

Specific risk factors for a VSD include being of Asian heritage, having a family history of congenital heart disease, and having other genetic disorders, such as Down syndrome.

Your doctor will listen to you or your baby’s heart through a stethoscope, take a complete medical history, and will perform several types of tests, including the following:

  • A transesophageal echocardiogram (TEE) is a picture taken by numbing the throat and then sliding a thin tube containing an ultrasound device down the throat and into the esophagus, close to the heart.
  • An echocardiogram with an agitated saline bubble test is an ultrasound taken of the heart while saline bubbles are injected into the bloodstream.
  • An MRI involves the use of radio and magnetic waves to take images of the heart.

Wait-and-Watch Approach

If the VSD is small and not causing any symptoms, your doctor may recommend a wait-and-watch approach to see if the defect corrects itself. Your doctor will carefully monitor you or your baby’s health to make sure your condition improves.


In more severe cases, surgery is required to repair the damage. Most surgeries to correct a VSD are open-heart surgery. You’ll be anesthetized and put on a heart-lung machine. Your surgeon will make an incision in your chest and close the VSD with either stitches or a patch.

A catheter procedure involves inserting a thin tube, or catheter, into a blood vessel in the groin and then guiding it all the way up to the heart for closure of the VSD.

Other surgeries involve a combination of these two procedures.

If the VSD is large, you or your child may need medication to control symptoms before surgery. Medication may include digoxin, a drug made from the foxglove plant, Digitalis lanata, and possibly diuretics as well.

In babies with small defects and no symptoms, your doctor will monitor your child to see if the VSD closes on its own. They’ll also make sure symptoms don’t develop.

Surgery has a high success rate and excellent long-term outcomes. Recovery time will depend on the size of the defect and whether there are any additional health or heart problems.