Ventricular Septal Defects: Facts and Resources About the Congenital Heart Disease

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Walls between chambers of the heart may have a hole, which usually develops before a baby is born.  It usually is found in infants.  The ventricles are the two chambers located on the bottom portion of the heart.  The wall between both of them is called the septum.  A septal defect is a hole in the septum.  Therefore, ventricular septal defect (VSD) is a congenital heart disease characterized by a hole in the wall between the left and right ventricles of the heart. Meanwhile, atrial septal defect (ASD) is a hole in the wall between the right and left atria (upper chambers).  It is even possible that newborns can have both types of disorders.  Medical professionals usually use the phrase, “holes in the heart,” when referring to any septal defects.

Right Ventricle

The contraction of the right ventricle isn’t affected by the ventricular septal defect, which causes the pressure generated during the simultaneous contraction of the left ventricle to be elevated.  Shunted refers to the blood being pushed through the VSD from the left ventricle to the right side.  The excess blood volume will make the right ventricle to do extra work in order to handle the extra load.  There’s a chance the right ventricle will have difficulties to deal with the blood.  If it does, then it would become enlarged and loses its capability to efficiently pump.  Moreover, the lungs receive too much blood under too much force.  The extra blood under excess pressure causes the arterioles (small arteries) in the lungs to thicken.  Everlasting injury can be done to the lungs if the more than usual exertion endures.

Size of the Hole

The size of the ventricle septal defect does make a distinguished difference on the degree exertion.  It is common that the defects are tiny and being less than 0.5 square cm.  There is low amount of shunting of blood when the VSD is small.  Also, the right ventricle is just experiencing normal pressure.  The lung arterioles won’t have any damages; the functioning of the heart is normal.  Therefore, the only way a medical professional notices a VSD is by noticing a conspicuous murmur, which is ordinarily noted during the first week of life, heard through a stethoscope.  That is usually the only way doctors detect VSD on a baby.

Most Common Congenital Disease

The most common congenital heart disorder is ventricular septal defect, which occurs between 0.1 to 0.4 percent of all live births and makes up approximately 20 to 30 percent of congenital heart lesions.  The defect can happen in different locations and be of various sizes, which partly ascertain the consequences of VSD.  Different types of tissue make up the ventricular septum:  one part is comprised of mostly muscle and another one is made out of thinner, fibrous tissue.

Systolic Murmurs

Tiny ventricle septal defects seldom cause problems.  These holes are usually detected during a routine physical exam when a systolic murmur is heard.  Murmurs, extra heart sounds, are audible by placing a stethoscope along the breast bone or lower left sternal.  The sound is associated to the oxygenated blood “swishing” through the VSD into the right ventricle.  During the first few days of life, murmurs usually don’t exist.  The small holes will close on their own, especially if they are in the muscular portion of the septum.  If the holes stay open, they rarely will cause any health problems.  Nevertheless, the babies should have their VSD continue to be examined as they get older.  These holes can be related with the development of other heart-related problems that with time may become palpable.

Medium and Large Ventricular Septal Defects

Ventricle septal defects that are medium-sized are not easy to predict.  Some babies born with moderate VSD need to be observed while they don’t have any heart problems as they become older.  Others will have problems with congestive heart failure (CHF) similar to what babies with large VSD experience.

Often developing gradually in the initial months of life, large ventricular defects can cause problems.  As soon as the baby is out of its mother’s womb, the pressure in the lungs and the right side of the heart starts to dwindle.  In contrast, the pressure on the left side is the same as the right side before a baby’s birth.  In a deliberate process, it takes about 2 to 4 weeks for the pressure in the lungs to go back to its normal level.  Newborns during their first one to two weeks of life may not have any problems.  When there are symptoms of congestive heart failure (CHF), the person must be treated.

A large hole may make a softer noise than a smaller one.  Also, the murmur could be louder as the ventricle septal defect starts to enclose.  The most important sign of congestive heart failure is the growth of the baby.  Having significant CHF will make the babies incapable of flourishing and have trouble maintaining normal babies gain during the first few months of its life.  [3]

Monitoring the Hole in the Heart

Ventricular septal defects are capable of becoming smaller or even close by itself.  Thus, most cardiologists will closely monitor their patients and attempt to treat the symptoms of congestive heart failure.  They will prescribe medications so that they will have time to decide if the defect will eventually close.  The doctors would recommend surgery once they sense the VSD will not close.

Surgery is Necessary

To treat a patient with a large ventricle septal defect, a surgery needs to be done to “patch the hole.”  There are several factors to consider when determining when it should be done.  Surgeons need to consider the duration and the extent of abundant pulmonary artery pressure.  It is possible that doctors cannot redirect a patient’s chronic pulmonary arteriolar pressure, which can create impairment on the right ventricle.  Those conditions may be treated with medications until surgery is finished.

Two Types of Surgeries to Consider

One type of surgery available to correct a ventricle septal defect is the intra-cardiac technique.  That is the most common use; the patient goes under cardiopulmonary bypass (heart-lung machine).  The other type that is available is called trans-catheter technique.  This one is more difficult and should only be considered for selected patients and at pediatric centers that have expertise on it.  Surgeons use surgical instruments that are passed through catheters placed in the patient’s large blood vessels going into the heart.

Resources About Ventricular Septal Defect

Medicine Net – We Bring Doctors’ Knowledge to You

Emedicine Health – Experts for Everyday Emergencies

Cincinnati Children’s Hospital Medical Center

Cleveland Clinic

Medic 8 – Your Trusted Source for Health Information Online

Resource by S.Lee

I like to read, write, draw, paint, and use computers.

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