Ventricular Septal Defect – Symptoms and Causes
Overview
A heart wall opening, also known as a ventricular septal defect (VSD), is a common heart condition present from birth. This hole occurs in the wall dividing the heart’s lower pumping chambers.
When this opening exists, blood flow through the heart changes in important ways. Oxygen-rich blood flows back to the lungs instead of moving forward to the body.
This abnormal blood flow pattern can create several problems. The heart must work harder to pump enough blood. In some cases, blood pressure in the lungs may increase. The severity of these issues depends on the size of the opening.
Small openings often cause no symptoms and may close without treatment. Many babies with small VSDs develop normally without intervention. However, medium or large openings typically require surgical repair early in life to prevent complications.
Symptoms
A ventricular septal defect (VSD) may show different signs depending on the hole’s size and any accompanying heart issues. Some small VSDs cause no symptoms at all.
Babies with VSDs might show several concerning signs. They often struggle with feeding and may not grow at a normal rate, a condition doctors call failure to thrive.
Parents might notice rapid breathing, breathlessness, or that their baby tires easily during normal activities.
When healthcare providers examine these infants, they frequently detect a heart murmur, which sounds like a whooshing noise when listening with a stethoscope.
Adults with VSDs typically experience fewer symptoms. The most common problems include:
- Shortness of breath, particularly during physical activity
- Heart murmur detected during medical examinations
These symptoms can affect daily life and should prompt a medical evaluation if they appear suddenly or worsen over time.
When to See a Doctor
Contact your child’s doctor if you notice signs that might point to a health issue. These include:
- Getting tired easily during feeding or play
- Poor weight gain
- Breathing problems when eating or crying
- Fast breathing
For both children and adults, seek medical help if you experience:
- Trouble breathing
- Heart beating too fast or irregularly
- Feeling unusually tired or weak
These symptoms could indicate a serious condition that needs prompt medical attention.
Causes
Heart Function
The heart serves as the body’s main pump, moving blood through the body. It beats about 100,000 times daily, pushing blood to deliver oxygen and nutrients to all body parts.
The heart has its own electrical system that creates regular heartbeats. Blood always flows in one direction through the heart because of special one-way valves.
The heart muscle needs its own blood supply to work well. When someone has a ventricular septal defect (VSD), this normal function changes.
Heart Structure
The heart contains four main sections and several valves that control blood flow. The upper chambers (atria) collect blood returning to the heart. The lower chambers (ventricles) do the main pumping work.
The four chambers include:
- Right Atrium: Collects oxygen-poor blood from the body.
- Right Ventricle: Pumps blood to the lungs.
- Left Atrium: Receives oxygen-rich blood from the lungs.
- Left Ventricle: Pumps oxygen-rich blood to the body.
In a healthy heart, blood flows in a specific path. First, oxygen-poor blood enters the right side of the heart. This blood travels to the lungs to pick up oxygen.
Then, oxygen-rich blood returns to the left side of the heart. Finally, this blood gets pumped out to the rest of the body.
A VSD creates a hole in the wall between the two ventricles. This hole forms during pregnancy when the heart develops. The hole allows blood to flow between chambers that should be separate. When this happens:
- Oxygen-rich blood leaks back into the lungs instead of going to the body.
- The heart must work harder to pump enough blood.
- Blood pressure in lung arteries may increase.
- Blood flow in lung arteries increases, causing congestion.
Most VSDs happen for unknown reasons. Some may have genetic links or connect to other heart problems present at birth. Rarely, a VSD can develop after a heart attack damages the heart wall.
Risk Factors
Several factors can increase the chance of having a ventricular septal defect:
- Being born too early (premature birth)
- Genetic conditions like Down syndrome
- Family history of birth heart defects
Children born with this heart condition often have other heart problems at the same time, including:
- Holes between the upper heart chambers (atrial septal defect)
- Narrowing of the aorta
- Double outlet syndrome
- Patent ductus arteriosus
- Tetralogy of Fallot
Complications
Small holes in the heart wall between the ventricles might never cause problems. However, medium to large defects can lead to serious health issues without proper treatment.
Heart failure is a major concern with larger defects. The heart must work harder than normal, and too much blood flows to the lungs. This extra strain can damage the heart over time if not addressed.
After many years, an untreated defect may lead to a serious condition where lung blood vessels become stiff and narrow. This causes high blood pressure in the lung arteries, permanently damaging these vessels.
Infection of the heart’s inner lining is a rare but dangerous complication. This inflammation affects the heart chambers and valves and requires immediate medical attention.
Other possible problems include:
- Damage to heart valves
- Irregular heartbeats
- Breathing difficulties
- Delayed growth in children
Prevention
Taking steps to lower the risk of ventricular septal defect (VSD) in a baby is important, especially for those planning a pregnancy. While not all VSDs can be prevented, these actions may help:
Before Pregnancy
- Get Early Healthcare: See your doctor before trying to become pregnant to discuss your health. Also, talk about any needed lifestyle changes.
- Consider Genetic Counseling: If heart defects run in your family, speaking with a genetic counselor can help you understand the risks.
During Pregnancy Planning
- Take Folic Acid Daily: 400 micrograms of folic acid can reduce birth defects, possibly including heart defects.
- Get Vaccinated: Ensure you’re protected against infections like rubella (German measles) that can harm heart development.
- Review Medications: Check with your doctor about any medicines you take, as some may cause birth defects.
Lifestyle Changes
- Avoid alcohol completely during pregnancy.
- Quit smoking before becoming pregnant.
- Stay away from illegal drugs.
- Maintain healthy blood sugar levels if you have diabetes.
For Those with Diabetes
Controlling blood sugar before and during pregnancy is crucial. Gestational diabetes (diabetes that develops during pregnancy) doesn’t typically increase VSD risk, but pre-existing diabetes requires careful management.
Medication Safety
| Medication Type | Action Needed |
|---|---|
| Prescription drugs | Discuss with your doctor before pregnancy |
| Over-the-counter medicines | Check safety with healthcare provider |
| Supplements | Review all with medical professional |
Many women with VSDs have healthy pregnancies and babies. Regular prenatal checkups and following medical advice increase the chances of a healthy outcome for both mother and baby.
