What is VSD?

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.

Ventricular septal defect 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.

Hole in the heart 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.

Diagnosis of ventricular septal defect

At Ohio State, we ensure that each patient receives individualized care for their congenital heart defect. By creating a care team to diagnose and treat each case, we can better understand what steps will help patients get back to living their lives.

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Ventricular septal defect treatment

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 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

Hole in the heart 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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