A ventricular septal defect is congenital heart disease. Congenital heart defects are problems with the heart’s structure that are present at birth. Congenital heart defects also known as a hole in a heart. this disease changes the normal blood flow to the heart. Ventricular septal defect commonly known as VSD is a hole between the hearts lower chamber. this defect can occur anywhere in chamber muscle that divides the two sides of the heart. VSD’s are the most common congenital heart defect.
VSD is more common than Atrial Septal Defect (ASD). VSD’s are trickier as they have a hole between the pumping chamber of the heart. The amount and the pressure of the blood going to the lung complicates the VSD as compared to the ASD. Our heart has two sides, separated by an inner wall called the septum. ASD and VSD defect allows blood to pass from the left side of the heart to right side.
This means the rich oxygen blood can mix with poor oxygen blood. sometimes the oxygen-rich blood is pumped to the lungs instead of the body.
VSD can be small, medium or large:
A small VSD may close by their own as small VSD allows a small amount of blood flow between the ventricles. Small VSD’s doesn’t cause any symptoms.
Medium VSD’s are less likely to close by their own, it may require the surgery and may show symptoms.
Large VSD needs surgical repair early in life to prevent complications. Large VSDs often cause symptoms in infants and children. Usually, large VSD’s have to be close by the 6th month of age because if kept untreated for a long time it may cause damage to the lungs.
Dr.Suresh Rao says” In a new-born child, some VSD’s tends to come down in size in a few months’ time. And some of them may be lucky to close on its own. Whenever we see a VSD in the new-born child we don’t try to rush in and close the VSD. If it is only a VSD and not with any other problem, we try to give a child a months’ time, monitor it closely on how it feeds, how it grows and at the end of one month usually the VSD shows itself, how it is going to behave in future”.
Ventricular septal defect Symptoms:
(VSD) symptoms in a baby may include:
- Pale skin coloration
Becomes breathless when eating or crying
Is not gaining weight
Frequent respiratory infections
A child turns bluish especially around the lips and fingernails
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A child born with VSD may have a single hole or more than one hole in the wall that separates the two ventricles.
Doctors classify VSD’s based on the:
- Size of the defect.
Location of the defect.
A number of defects.
Presence or absence of a ventricular septal aneurysm-a thin flap of tissue on the septum.
What are the causes of Ventricular septal defect?
Congenital heart defects arise early when the child’s heart if form in the mother’s womb. Genetics and environmental factors may play a major role. VSD may occur alone or with other heart issues (congenital heart defects)
Children who have a genetic disorder like Down syndrome often have a congenital heart defect. Smoking during pregnancy also linked to several congenital heart defects.
“There are few VSD’s which can close non-surgically also. But this usually happens in older children, and if VSD’s are away from some of the important structure of the heart. they have to be chosen very carefully by the cardiologist depending on the ECHO” – says Dr.Suresh Rao a pediatric cardiologist from Kokilaben Dhirubhai Ambani Hospital.
- Small VSD’s may never cause any problem. Medium and large VSD can cause some disabilities.
Heart failure- A heart with medium or large VSD heart need to pump enough to the body.
Endocarditis. This is a heart infection.
Pulmonary hypertension- This complication can cause a reversal of blood flow through the hole.
Other heart problems.
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Get early parental care.
Eat a balanced diet.
Avoid alcohol, tobacco and illegal drugs.
vaccinations before becoming pregnant.
Keep diabetes under control.
How Are Ventricular Septal Defects Diagnosed?
Usually, VSD is found in the first weeks of life by the doctors during a routine check-up. doctor listen to babies’ VSD murmur sound through a stethoscope. The cardiologist will do an examination and take your child’s medical history. If the doctor suspects VSD, the cardiologist may order one or more of these tests:
- A chest x-ray- picture of heart other organs
An electrocardiogram (EKG) -This is often the primary tool used to diagnose a VSD.
A cardiac catheterization – this provides information about the heart’s structures and the blood pressure and blood oxygen levels in its chambers.
Treating Ventricular Septal Defect (VSD):
The doctor will observe children who have ventricular septal defects. Small VSD close before the child goes to school. Generally, the VSD’s operates anywhere between two to three months upwards. large VSD’s have to be close by the 6th month of age.
The doctor may recommend surgery if your child has VSD:
- Is large
Is causing symptoms
Is medium-sized and is causing enlarged heart chambers
Affects the aortic valve
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How are Ventricular Septal Defects Treated?
VSD treatment depends on a child’s age, VSD size, location, and severity. There are few VSD’s which can be close by non-surgically also. non-surgical usually happens in older children. If the VSD’s are away from some of the important structure of the heart. They have to be chosen very carefully by the cardiologist depending on the ECHO.
Wait and watch approach:
If the VSD is small and but causing any symptoms then a doctor may recommend wait and watch approach. Your pediatric cardiologist will carefully monitor your baby’s health to make sure your babies condition improves.
Ventricular Septal Defect Surgery:
For large VSD doctor will recommend surgery. The surgery is required to repair the damage. Most surgeries to correct a VSD are open-heart surgery. surgery may be needed if:
- The child fails to gain weight.
Medicines are needed to control the symptoms of heart failure
In some VSD cases, the kids need to follow up unto 5-7 years of the age, especially those with large VSD and high lung pressure. They need a follow up to see what is happening to the lung pressure. Even a small percentage can continue to have high lung pressure.