Ventricular septal defects are the most common heart defect in newborn babies.

A ventricular septal defect (VSD) is a common congenital heart defect characterized by a hole between the two lower chambers of the heart. This condition causes blood from the left ventricle to flow back into the right ventricle. It is sometimes referred to as a “hole in the heart.” Ventricular septal defects are the most common congenital heart defect in newborn babies.

In mild cases the only symptom may be a heart murmur. In more severe cases, infants or children may have poor growth, breathing problems, and difficulty eating or sweating. If a defect is large and left unrepaired, adults may become cyanotic (bluish discoloration of the skin due to low oxygen levels in the blood) and develop heart failure.

Causes

Like other congenital heart defects, ventricular septal defect occurs during fetal development. The cause is unknown, but genetics may play a role. If members of your family have ventricular septal defect, you may want to consult with a genetic counselor who may recommend genetic testing.

Symptoms

When a baby has a serious heart defect, symptoms may become apparent in the first days, weeks or months of life. Symptoms of a large ventricular septal defect include:

  • Fatigue
  • Fast breathing
  • Rapid heart rate
  • Swelling of feet, legs and abdomen
  • Failure to thrive

Smaller ventricular septal defects may close on their own or may cause no symptoms.

Why choose Ohio State for ventricular septal defect treatment?

Ohio State’s Wexner Medical Center offers a team approach to congenital heart disease (CHD), which means each patient is evaluated by an Adult Congenital Heart Disease (ACHD) specialist, and when appropriate, a cardiac surgeon, an imaging specialist and an interventional cardiologist with training in CHD. This integrated approach means that each patient’s disease is treated individually, with that particular patient’s needs, and physical condition, in mind.

Anyone who has ever been diagnosed with and/or treated for ventricular septal defect should have lifelong care from a cardiologist who specializes in congenital heart defects. The Ohio State University Wexner Medical Center provides this care from birth to adulthood. We partner with Nationwide Children’s Hospital to provide the resources necessary for the care of adult congenital cardiac patients through the Columbus Ohio Adult Congenital Heart Disease Program (COACH).

The COACH program focuses on:

  • Adults with congenital heart disease (CHD)
  • Pulmonary hypertension
  • Cardiovascular connective tissue disorders
  • Pregnancy in women with heart disease
  • Transition of adolescents with CHD into adult congenital heart disease (ACHD) care
  • Training of future ACHD providers

Diagnosis

Due to improvements in technology, some congenital heart defects can be detected before a baby is born. In other cases, severe heart defects are detected shortly after birth. Some cases of less severe disease may not be detected until childhood, late adolescence or even adulthood.

Tests used to diagnose ventricular septal defect include:

Electrocardiogram (EKG/ECG) – A test that records the electrical activity of the heart.

Echocardiogram (also called echo) – A test that uses sound waves to assess the function and structure of the heart muscle and valves.

Chest X-ray – A radiograph or picture of the heart and lungs including blood vessels, ribs and bones of the spine.

Cardiac MRI (cardiac magnetic resonance imaging or CMR) – A noninvasive, sophisticated imaging procedure that uses large magnets and a computer to produce detailed images of the structure and function of the heart while it is beating.

Cardiac catheterization – A procedure to measure pressures in the heart and to check for problems in the coronary arteries. A long, thin tube (catheter) is inserted into an artery or vein in the groin, arm or neck, and then threaded to the heart. The physician injects a contrast solution into the artery and takes X-rays to check for blockage and other abnormalities.

Treatments

A majority of ventricular septal defects will close spontaneously by the age of six. If the defect does not close sufficiently, surgery may be required. Medications can be used to treat symptoms until the defect is closed.

Medications

Medications may help relieve symptoms from ventricular septal defects, such as weak heart contractions and excess fluid. Medications prescribed may include:

  • Angiotensin receptor blockers (ACE-inhibitors)
  • Beta-blockers
  • Digoxin
  • Diuretics

Surgery

Most babies diagnosed with a small ventricular septal defect will not need surgery because the defect may close on its own. When symptoms become problematic or the ventricular septal defect is large, surgical repair may be recommended. This usually involves open heart surgery.

Minimally invasive procedures have been performed in the cardiac catheterization suite; however, this is not done on a routine basis.

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