A ventricular septal defect (VSD) is a hole between the lower 2 chambers of the heart.
The heart has 4 sections, or chambers. The upper chambers are called atria, and the lower chambers are called ventricles. The wall between the 2 ventricles is called the ventricular septum.
Normally, blood flows from the right atrium into the right ventricle, and the right ventricle pumps it to the lungs. When there is a hole in the ventricular septum, oxygen-rich blood from the left ventricle flows into the right ventricle. Then it is pumped back to the lungs, even though this blood does not need oxygen. This makes the heart and lungs work harder.
What is the cause?
A VSD is found most often in babies. It happens before birth and is the most common birth defect of the heart. Often it is the only defect, but sometimes there are other heart defects as well. Most of the time the cause of the birth defect is not known. Heart defects may be inherited, which means that that they are passed from parents to children through their genes. Genes are inside each cell of your body. They contain the information that tells your body how to develop and work.
Rarely, an injury to the heart or a heart attack may cause a VSD.
What are the symptoms?
If the defect is mild, there may be no symptoms. It may be found only when being tested for something else. Many defects cause a whooshing sound, called a murmur, as blood moves through the heart. Healthcare providers can hear the murmur with a stethoscope.
Large defects may cause symptoms. Symptoms may include:
Shortness of breath
Fluid in the lungs and other body tissues
Symptoms of low blood pressure, such as dizziness or feeling tired all the time
How is it diagnosed?
Your healthcare provider will ask about your symptoms and medical history and examine you.
Tests may include:
A chest X-ray
An ECG (also called an EKG or electrocardiogram), which measures and records the heartbeat
An echocardiogram, which uses sound waves (ultrasound) to see how well the heart is pumping
You may have other tests to check for possible causes of your symptoms.
How is it treated?
Your healthcare provider will advise treatment based on the symptoms and size of the defect.
A small defect may never cause any symptoms or problems. The smaller the defect, the greater the chance that it will close on its own, usually in the first years of a childâ€™s life. People with a small VSD may lead normal lives.
Medium and large ventricular septal defects may need to be fixed with surgery or heart catheterization.
Two types of surgery may be done to close the defect:
Heart catheterization, which uses a small tube called a catheter inserted into a blood vessel, dye, and X-rays to look at the blood vessels and heart. The healthcare provider will use tools put through the catheter to repair the defect. The hole may be closed by sewing it, patching it with a small piece of tissue from another part of the heart, or by plugging the hole with a small metal or plastic device.
Open heart surgery to close the defect may be needed if it is large or if there are other heart defects.
When a heart attack causes a septal defect, your provider may wait about 2 weeks after the heart attack to do surgery.
How can I take care of myself?
Follow your healthcare provider’s instructions. Ask your provider:
How and when you will hear your test results
How long it will take to recover
If there are activities you should avoid and when you can return to your normal activities
How to take care of yourself at home
What symptoms or problems you should watch for and what to do if you have them
Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.
Developed by RelayHealth.
Adult Advisor 2015.1 published by RelayHealth. Last modified: 2014-12-08 Last reviewed: 2014-12-08
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Ventricular Septal Defect: References
Warnes CA, Williams RG, Bashore TM, et al. (2008). ACC/AHA 2008 Guidelines for the Management of Adults with Congenital Heart Disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to develop guidelines on the management of adults with congenital heart disease). Circulation; 118:e714.
Gersony, WM. Natural history and decision-making in patients with ventricular septal defect. Prog Pediatr Cardiol 2001; 14:125.
Hijazi, ZM, Awad, SM. Pediatric cardiac intervnetions. J Am Coll Cardiol Intv 2008;1:603.
Kliegman, Robert M. Nelson Textbook of Pediatrics, 19th Edition. Saunders. 2011.
Otterstad, JE, Froysaker, T, Erikssen, J, Simonsen, S. Long-term results in isolated ventricular septal defect surgically repaired after age 10. Comparison with the natural course in similarly-aged patients. Scand J Thorac Cardiovasc Surg 1985; 19:221.
Rudolph, AM. Ventricular Septal Defect. In: Congenital Diseases of the Heart: Clinical-Physiological Considerations, Rudolph, AM (Ed), Futura Publishing Company, New York 2001. p.197.
Wilson, W, Taubert, KA, Gewitz, M, et al. Prevention of Infective Endocarditis. Guidelines From the American Heart Association. A Guideline From the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation 2007; 115 published online April 19, 2007.