What is the vsd?

A ventricular septal defect (pronounced ven·tric·u·lar sep·tal de·fect) (VSD) is a birth defect of the heart in which there is a hole in the wall (septum) that separates the two lower chambers (ventricles) of the heart. This wall also is called the ventricular septum.

A ventricular septal defect happens during pregnancy if the wall that forms between the two ventricles does not fully develop, leaving a hole. A ventricular septal defect is one type of congenital heart defect. Congenital means present at birth.

In a baby without a congenital heart defect, the right side of the heart pumps oxygen-poor blood from the heart to the lungs, and the left side of the heart pumps oxygen-rich blood to the rest of the body.

In babies with a ventricular septal defect, blood often flows from the left ventricle through the ventricular septal defect to the right ventricle and into the lungs. This extra blood being pumped into the lungs forces the heart and lungs to work harder. Over time, if not repaired, this defect can increase the risk for other complications, including heart failure, high blood pressure in the lungs (called pulmonary hypertension), irregular heart rhythms (called arrhythmia), or stroke.

Learn more about how the heart works »

An infant with a ventricular septal defect can have one or more holes in different places of the septum. There are several names for these holes. Some common locations and names are (see figure):

In a study in Atlanta, the Centers for Disease Control and Prevention (CDC) estimated that 42 of every 10,000 babies born had a ventricular septal defect.1 This means about 16,800 babies are born each year in the United States with a ventricular septal defect. In other words, about 1 in every 240 babies born in the United States each year are born with a ventricular septal defect.

The causes of heart defects (such as a ventricular septal defect) among most babies are unknown. Some babies have heart defects because of changes in their genes or chromosomes. Heart defects also are thought to be caused by a combination of genes and other risk factors, such as the things the mother comes in contact with in the environment or what the mother eats or drinks or the medicines the mother uses.

Read more about CDC’s work on causes and risk factors »

A ventricular septal defect usually is diagnosed after a baby is born.

The size of the ventricular septal defect will influence what symptoms, if any, are present, and whether a doctor hears a heart murmur during a physical examination. Signs of a ventricular septal defect might be present at birth or might not appear until well after birth. If the hole is small, it usually will close on its own and the baby might not show any signs of the defect. However, if the hole is large, the baby might have symptoms, including:

During a physical examination the doctor might hear a distinct whooshing sound, called a heart murmur. If the doctor hears a heart murmur or other signs are present, the doctor can request one or more tests to confirm the diagnosis. The most common test is an echocardiogram, which is an ultrasound of the heart that can show problems with the structure of the heart, show how large the hole is, and show how much blood is flowing through the hole.

Treatments for a ventricular septal defect depend on the size of the hole and the problems it might cause. Many ventricular septal defects are small and close on their own; if the hole is small and not causing any symptoms, the doctor will check the infant regularly to ensure there are no signs of heart failure and that the hole closes on its own. If the hole does not close on its own or if it is large, further actions might need to be taken.

Depending on the size of the hole, symptoms, and general health of the child, the doctor might recommend either cardiac catheterization or open-heart surgery to close the hole and restore normal blood flow. After surgery, the doctor will set up regular follow-up visits to make sure that the ventricular septal defect remains closed. Most children who have a ventricular septal defect that closes (either on its own or with surgery) live healthy lives.

Some children will need medicines to help strengthen the heart muscle, lower their blood pressure, and help the body get rid of extra fluid.

Some babies with a ventricular septal defect become tired while feeding and do not eat enough to gain weight. To make sure babies have a healthy weight gain, a special high-calorie formula might be prescribed. Some babies become extremely tired while feeding and might need to be fed through a feeding tube.

A ventricular septal defect is a condition where you're born with a hole in the wall between the two lower chambers of your heart. Often shortened to VSD, this condition is the most common congenital (meaning you have it when you're born) heart defect and often happens alongside other types of heart problems or defects. A small VSD is usually minor and has few or no symptoms. However, a larger hole may need to be repaired to avoid permanent damage and complications.

Your heart has four chambers. To pump blood efficiently, the chambers much seal shut. A VSD is a leak that disrupts that efficient pumping ability.

Under normal circumstances, the right ventricle pumps oxygen-poor blood that just arrived from your body out of your heart and into your lungs so the blood can pick up oxygen. The blood then returns to the heart, and its last stop in the heart is the left ventricle, which pumps oxygen-rich blood out to your entire body.

A VSD is a potential problem because it can act as a shunt (a connection) between the heart's two lower chambers, the left ventricle and the right ventricle. Because the pressure in the left ventricle is higher than the pressure in the right ventricle, oxygen-rich blood mixes with oxygen-poor blood in the right ventricle and then goes to the lungs. That leads to extra blood in the lungs which can cause serious problems.

Almost all VSDs are present at birth. A VSD diagnosis most likely happen during childhood, though adults can also receive this diagnosis. However, this only happens in 10% or less of cases. VSD is also slightly more likely to happen in premature babies and babies with certain genetic conditions.

In very rare cases, a heart attack can tear a hole between the ventricles and create a VSD. While this type of VSD — sometimes called ventricular septal rupture (VSR) — is technically a side effect, it is still a dangerous problem that needs to be repaired.

VSD happens in about one-third of 1% of all newborns. However, a VSD diagnosis in adults is much less likely because the defect closes on its own during childhood in 90% of cases.

VSDs that are a side effect of a heart attack are extremely rare, especially because of modern heart attack treatment methods. Today, it happens in less than 1% of all heart attacks.

There are four main types of VSD, which differ in their location and the structure of the hole (or holes). The types of VSD are:

VSD doesn't cause symptoms in most cases because the hole isn't large enough to cause problems. However, in cases where the hole is large enough (or if there are multiple holes), it can cause problems with blood leaking between the two chambers instead of circulating through the heart in the correct order.

That leaking makes your heart's pumping efforts less efficient, though if the leak is smaller, it may not be enough to cause any symptoms or problems. However, your heart needs to pump harder to compensate for the reduced blood flow when the leak is larger. When your heart works harder like that long-term, it can cause symptoms and problems in the heart and lungs that may become severe.

VSDs range in size from small to large, with the size playing a role in what effects — if any — the VSD will cause.

When a moderate or large VSD is not treated in time, Eisenmenger syndrome can develop. This is a condition where long-term damage to blood vessels in the lungs forces oxygen-poor blood from the right ventricle through a large VSD and into the left ventricle. That means some of the blood pumped to the body doesn't contain enough oxygen. That causes an overall oxygen shortage throughout the body. This condition is typically severe and can have major consequences on a person’s life and the activities in which they can participate.

The left ventricle has greater pumping strength than the right, which means it can force blood into the right ventricle. The right ventricle can’t push the extra blood back, so the extra blood instead gets pumped into the lungs. That puts too much pressure on and damages the lung’s blood vessels. Over time, the damage in the lung’s blood vessels starts to force the leak in the heart to reverse direction, forcing oxygen-poor blood from the right ventricle into the left.

• Shortness of breath.
• Fast breathing.
• Hard breathing.
• Paleness.
• Failure to gain weight.
• Fast heart rate.
• Sweating while feeding.
• Frequent respiratory infections.

A ventricular septal defect (VSD) is a congenital heart defect. This means that your baby is born with it. A VSD is a hole in the  wall (septum) that separates the 2 lower chambers of the heart (right and left ventricles). VSDs are the most common type of congenital heart defect.

The heart has 4 chambers: 2 upper (atria) and 2 lower (ventricles). Blood that is high in oxygen flows from the left atrium to the left ventricle and out to the body, where the vital organs use the oxygen. Blood with less oxygen flows from the right atrium to the right ventricle and out to the lungs. In the lungs it picks up more oxygen.

Normally. the septal wall prevents the mixing of blood between the two ventricles of the heart. A VSD allows oxygen-rich (red) blood to pass abnormally from the left ventricle through the opening in the septum. Then it mixes with oxygen-poor (blue) blood in the right ventricle.

A large VSD can cause high pressure in the blood vessels in the lungs. The higher pressure can lead to lower oxygen levels in the body. If your child has a larger VSD, he or she may need some type of repair. Babies and children with larger VSDs often have symptoms such as breathing faster and harder than normal. Very small holes in the ventricular septum may not let much blood pass between the ventricles. In these cases, the heart and lungs don’t have to work harder. Sometimes these small holes will close up on their own.

There are different types of VSD. The type your child has depends on which part of the wall between the ventricles is involved. The size of the opening or hole also varies.

VSD may occur more often in some families. This is because of gene problems. Most of the time, doctors don't know the cause of VSD.

Your child may have symptoms from birth. Or your child may not have symptoms until they are a little older. The size of the opening or hole affects how severe your child’s symptoms are. So does the age at which your child first has symptoms. If the hole is small, the only sign may be a heart murmur that your healthcare provider hears with a stethoscope. With a larger opening, the heart and lungs have to work harder.

This can cause symptoms such as :

Symptoms can occur a bit differently in each child. The symptoms of VSD may also be similar to symptoms of other conditions. Make sure your child sees the healthcare provider for a correct diagnosis.

Your child's healthcare provider may suspect a problem when they hear an abnormal sound (heart murmur) when listening to your child's heart with a stethoscope. If this happens, the healthcare provider may refer your child to a heart doctor for children (pediatric cardiologist).

The heart doctor will check your child. He or she will listen to your child’s heart and lungs. The details about the murmur will also help the heart doctor make the diagnosis.

The heart doctor may do tests to confirm the diagnosis. The tests your child has depends on his or her age and condition, and the doctor’s preferences.

A chest X-ray shows the heart and lungs. With a VSD, a chest X-ray may show an enlarged heart. This is because the left ventricle gets more blood than normal. There may also be changes in the lungs because of extra blood flow.

This test records the electrical activity of the heart. It also shows abnormal rhythms (arrhythmias) and spots heart muscle stress.

An echo uses sound waves to make a moving picture of the heart and heart valves. This test can show the pattern and amount of blood flow through the septal opening. An echo is used to diagnose VSD.

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

A small VSD may close on its own as your child grows. Some small defects don’t close on their own, but they still don’t need treatment. A larger VSD often needs to be fixed with surgery or through cardiac catheterization. Once a child is diagnosed with a VSD, their heart doctor will check the defect regularly to see if it’s closing on its own.

Some children may need to take medicine to help the heart work better. Children without symptoms may not need medicine.

Babies with a larger VSD may get tired when feeding. They may not be able to eat enough to gain weight. They may need:

The goal of surgery is to close the septal opening before the lungs are damaged. Surgery will also help babies who have trouble feeding gain a normal amount of weight. Your child's heart doctor will decide when your child should have surgery. This may be based on echocardiogram and cardiac catheterization results. In surgery, your child’s doctor will close the VSD with stitches or a special patch. Ask your child’s heart doctor for more information.

VSD may be fixed by a cardiac catheterization. In this test, a tool called a septal occluder is used with a catheter. The doctor guides the catheter through the blood vessels to the heart. Once the catheter is in the heart, the doctor closes defect with the septal occluder. Only certain types of VSDs may be closed with this method. This procedure should be done in centers that have staff with experience in doing transcatheter VSD repair.

Complications of an untreated VSD include:

Babies with small VSDs may have no symptoms. These children may not need medicine. They’ll still be checked often by their heart doctors. If a defect is going to close, it usually happens by age 2 . But some defects don’t close until age 4 . These children usually grow and develop normally. They also have no activity restrictions, and live normal, healthy lives.

If the VSD is moderate to severe, your child’s heart doctor will closely monitor him or her. The doctor will decide when and how your child’s VSD will be fixed. Before surgery, your child may need medicine and special feedings. Your child's healthcare team will give you information and support so you can care for your child at home. Children who need surgery will be admitted to the hospital for surgery.

Babies who have trouble eating before surgery often have more energy right after surgery. They start to eat better and gain weight faster.

After surgery, older children can often be active without getting too tired. Within a few weeks, your child should be fully recovered. He or she should be able to do normal activities. Your child’s healthcare team may give you instructions on how to care for your child.

Most children who have surgery for VSD will live normal, healthy lives. Their activity levels, appetite, and growth often return to normal. Your child's heart doctor may give him or her antibiotics to prevent infections after leaving the hospital.

Ask your child's healthcare provider about your child’s outlook. When this condition is diagnosed early, the outcome is often excellent. The outlook may be poor when a VSD is diagnosed later in life, if complications occur after surgery, or if the VSD isn’t fixed. There is a risk for complications from a VSD. Children at risk for these problems should have follow-up care at a center that specializes in congenital heart disease.

Call the healthcare provider if your child has:

A heart defect due to an abnormal connection between the lower chambers of the heart (ventricles).