Ventricular Septal Defect
- endocardial cushion defect
Ventricular septal defect, also known as VSD, is a congenital defect of the heart, or one present at birth. There is an abnormal opening in the wall that separates 2 chambers of the heart.
What is going on in the body?
The heart has 4 chambers. Two of these chambers are called ventricles. The right ventricle and the left ventricle are separated by a wall or septum. A defect or hole in this wall causes blood to flow abnormally between these 2 chambers. Ventricular septal defect is one of the most common of the congenital heart diseases.
What are the causes and risks of the disease?
Although the cause of ventricular septal defect is unknown, it is more common with:
- infections in the pregnant woman, such as rubella
- Down syndrome
- alcohol abuse, poor nutrition, or diabetes in the pregnant woman
What can be done to prevent the disease?
Most cases of ventricular septal defect are not preventable. Lowering pregnancy risk factors, such as alcohol use, may prevent some cases.
How is the disease diagnosed?
Obtaining a full history and physical exam may lead a healthcare professional to suspect a ventricular septal defect.
Other tests that may be done to confirm the diagnosis may include:
- chest x-ray
- electrocardiogram, or ECG
- echocardiogram, or ultrasound of the heart and its blood flow
- cardiac catheterization, which is a special x-ray using a contrast agent
Long Term Effects
What are the long-term effects of the disease?
Long-term effects of a ventricular septal defect will vary depending on the size and location of the defect. Large defects or holes may cause difficulty breathing and weakening of the heart, inflammation or infection of the heart, or congestive heart failure.
What are the risks to others?
A ventricular septal defect is not contagious and poses no risk to others.
What are the treatments for the disease?
Treatment of a ventricular septal defect will depend on the size of the abnormal opening. Some people with small defects may not need any treatment, and the defect may just be monitored. Often small holes in the septum will close by themselves.
Someone with a larger defect often needs open heart surgery. Surgery to close the defect is usually very safe and effective. Surgery is often performed between the ages of 2 to 5 years, but can be done earlier. A child who has serious heart or lung problems from the defect may need other medical care before he or she is strong enough to undergo surgery. Antibiotics may be needed to prevent or treat any infections, such as lung or heart infections.
What are the side effects of the treatments?
All medications and surgeries have possible side effects. For example, antibiotics may cause stomach upset or allergic reactions. Surgery carries a risk of bleeding, infection, and allergic reaction to anesthesia. Medications used for treatment of congestive heart failure or arrhythmias may cause allergic reactions or salt imbalances.
What happens after treatment for the disease?
In uncomplicated cases, a person may return to normal activity after recovering from surgery. With more severe defects where heart or lung damage occurred, further treatment may be needed.
How is the disease monitored?
Blood tests as well as cardiac tests are often used to follow how the heart is functioning after surgery. Antibiotics will need to be administered before cleaning of the teeth or other dental work, and in other situations that could potentially allow bacteria to enter into the bloodstream, such as colonoscopy or urinary procedures.
Other monitoring of a person with a ventricular septal defect depends on the complications that develop. Any new or worsening symptoms should be reported to the healthcare professional.
Harrison's Principles of Internal Medicine, 1998, Fauci ET al.
Professional Guide to Diseases, fifth edition, Springhouse, 1995
CURRENT Pediatric Diagnosis&Treatment, Hathaway, et al, 1993