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Cardiovascular Disorders
Abdominal Aneurysm
Aortic Insufficiency
Aortic Stenosis
Arterial Occlusive
Atrial Septal Defect
Buerger's Disease
Cardiac Arrhythmias
Cardiac Tamponade
Cardiogenic Shock
Coarctation of the Aorta
Coronary Artery Disease
Dilated Cardiomyopathy
Femoral And Popliteal Aneurysms
Heart Failure
Hypertrophic Cardiomyopathy
Hypovolemic Shock
Mitral Insufficiency
Mitral Stenosis
Myocardial Infarction
Patent Ductus Arteriosus
Pulmonic Insufficiency
Pulmonic Stenosis
Raynaud's Disease
Rheumatic Heart Disease
Septic Shock
Tetralogy of Fallot
Thoracic Aortic Aneurysm
Transposition of The Great Arteries
Tricuspid Insufficiency
Tricuspid Stenosis
Varicose Veins
Ventricular Aneurysm
Ventricular Septal Defect (VSD)

Ventricular Septal Defect (VSD)

What is Ventricular Septal Defect?

Ventricular septal defect - the most common congenital heart disorder - is an abnormal opening in the ventricular septum that allows blood to escape from the left ventricle into the right. The result is that oxygenated blood returns to the lungs instead of moving into the aortic arch, as it should.

A ventricular septal defect may be large or small and may involve one hole or several holes in any part of the septum. Sometimes, the entire septum may be missing, which creates a single chamber. The amount of blood shunted between ventricles depends on the size of the defect and the amount of pulmonary and systemic resistance.

Up to 30% of smaller defects and 12% of larger ones close without treatment within a year after birth. Those that do - or those that are corrected surgically have a good prognosis. Untreated defects that don't close on their own can be fatal during the first year after birth, usually due to secondary complications.

Causes of Ventricular Septal Defect

Normally, the ventricular septum closes by the 6th week of gestation. However, in about 200 of 100,000 neonates, the septum fails to close, resulting in a ventricular septal defect. The condition may not be obvious right away because right and left ventricular pressures are nearly equal at birth (so blood doesn't shunt through the defect). However, 4 to 8 weeks after birth, pulmonary vessels gradually relax and right ventricular pressure decreases. Blood begins to shunt and symptoms arise.

Although no one knows what causes a ventricular septal defect, genetic and environmental factors may influence its development. Fetal alcohol syndrome may playa role. Although most children with congenital heart defects are otherwise normal. those with a ventricular septal defect may have other birth defects. These include Down syndrome and other autosomal trisomies, renal anomalies, and such cardiac defects as patent ductus arteriosus and coarctation of the arota.

Signs & Symptoms of Ventricular Septal Defect

  • breathing fast
  • breathing hard
  • failure to gain weight
  • fast heart rate
  • frequent respiratory infections in children
  • Rapid heart rate
  • paleness
  • pounding heart
  • shortness of breath
  • Swelling of legs, feet or abdomen

Diagnostic Tests

Chest X-ray - An X-ray image helps the doctor see the condition of your baby's heart and lungs. An X-ray may identify conditions other than a heart defect that may explain your baby's symptoms.

Electrocardiography results are normal for a small defect but show left and right ventricular hypertrophy (which suggests pulmonary hypertension) for a large defect. Large defects generate a right axis shift.

Echocardiography may reveal a large defect and its location in the septum, estimate the degree of a left-to-right shunt, suggest pulmonary hypertension, and identify associated lesions and complications.

Cardiac catheterization may be used to determine the size and location of the defect, to calculate the degree of shunting by comparing blood oxygen saturation between ventricles, to determine the extent of pulmonary hypertension, and to detect associated defects.


Only about 15% of small defects in infants require surgical correction. Infants who don't require surgery may receive an antibiotic to prevent bacterial endocarditis.

For an infant with a large defect, treatment focuses on managing heart failure and improving growth. Specifically, the infant may receive digoxin, diuretics, a sodium-restricted diet, and nutritional supplements. If this regimen is effective, surgery may be delayed to give the defect time to shrink or close on its own. Surgery for large defects usually requires insertion of a patch graft, usually through the tricuspid valve, with the patient on cardiopulmonary bypass. If the child has other defects and may benefit from delaying surgery, the doctor may band the pulmonary artery. This procedure normalizes pressures and blood flow distal to the band and prevents pulmonary vascular disease.

Usually, postoperative treatment includes mechanical ventilation, analgesics, diuretics to increase urine output, continuous infusion of nitroprusside or adrenergic agents to regulate blood pressure and cardiac output and, in rare cases, a temporary pacemaker.

Prevention Tips

In most cases, you can't do anything to prevent having a baby with a ventricular septal defect. However, it's important to do everything possible to have a healthy pregnancy. Here are the basics:

  • Exercise regularly.
  • Keep diabetes under control.
  • Get early prenatal care, even before you're pregnant.
  • Avoid alcohol, cigarettes and illicit drugs.


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