Ventricular Septal Defect
A ventricular septal defect (VSD) is a birth defect in the wall (septum) that separates the lower chambers of the heart. A VSD occurs in the womb when the wall does not fully develop, resulting in a hole that affects how blood travels through the heart. Depending on the hole’s size, further issues may develop. Adults may be diagnosed with a small VSD that went undetected as a child, or have the defect as a result of a heart attack. Most VSDs can be effectively treated, even if detected later in life.
There are four main types of VSDs, which are characterized by where the defect is located:
- Conoventricular ventricular septal defect occurs when the defect is below the pulmonary and aortic valves.
- Inlet ventricular septal defect occurs when the defect is close to where blood enters the ventricles through the tricuspid and mitral valves.
- Muscular ventricular septal defect, the most common type, occurs when the defect is located in the lower, muscular part of the ventricular septum.
- Perimembranous ventricular septal defect occurs when the defect is in the upper section of the ventricular septum.
If you have a VSD, you most likely experienced the following symptoms as a child:
- Frequent respiratory infections
- Inability to gain weight
- Quick, hard breathing
- Rapid heart rate
- Shortness of breath
Adults with a small, untreated defect may continue to experience shortness of breath.
Research is unclear of the exact cause of a VSD. Most cases appear to be genetic and cannot be prevented. However, some adults do develop VSDs after a heart attack, so reducing your risk of a heart attack by eating healthfully and exercising may help.
You may be at greater risk of developing a VSD if:
- Your mother drank alcohol or took antiseizure medicines during pregnancy.
- You have a family member with the condition.
- You experienced a heart attack as an adult.
- Clinical evaluation. Your healthcare provider will review your symptoms and look for signs of the condition. Your provider may use a stethoscope to detect a loud heart murmur, which is often the first step to receiving a diagnosis.
- Echocardiogram. This type of test is commonly used to diagnose a VSD. An echocardiogram uses sound waves to generate pictures of the heart. The test will show the size of the hole in the heart and how much blood is flowing through the hole.
- Imaging tests. A physician may order other tests to help confirm a diagnosis, including chest X-ray, heart MRI and electrocardiogram.
Most people born with a VSD have surgery to close the defect during infancy; however, a defect may be present in adults. If you experience endocarditis, which is a bacterial infection often resulting from a congenital heart defect, or low lung pressure, your physician may recommend repairing the defect with the following:
- Cardiac catheterization. This process is a less invasive procedure to repair a VSD than traditional open-heart surgery. During this procedure, a thin tube called a catheter is inserted into the groin and guided to the heart to patch the hole.
- Open-heart surgery. This is a common treatment to patch a defect, especially if the hole is large. A surgeon will sew both edges of the defect closed or patch the hole with a graft.
Whether you received treatment as a child or as an adult, you will need routine visits with a cardiologist who has experience in adult congenital heart disease. The cardiologist will monitor for any possible complications and give instructions for care.