Ventricular Septal Defect (VSD)

Overview

What is a ventricular septal defect (VSD)?

If your child has a ventricular septal defect, he or she has a small hole in the wall of muscle that separates the heart’s two pumping chambers, the left and right ventricles. This condition is sometimes called “hole in the heart.” The opening or hole may be in different parts of the heart wall, called the septum.   In some cases, there may be more than one hole.

The hole is formed when the septum doesn’t completely seal while a baby is developing in the womb. VSD is a congenital condition, meaning a child is born with it.

The severity of VSD and how it’s treated depends on the size of the hole and its location within the septum. Some VSDs are very small and close naturally on their own as a child grows. Larger VSDs may require surgery to close the hole.

Why is VSD a health concern?

Normally, the septum seals off the two ventricles from each other completely. But VSD allows blood from the high-pressure left ventricle to squirt into the lower-pressure right ventricle. This can make the heart work harder than it should and, over time, may lead to enlargement and heart failure.

Ventricular septal defects are one of the most common forms of congenital heart defects. They are usually diagnosed in infancy.

Programs & Treatments

How are ventricular septal defects (VSDs) treated?

If your child has a ventricular septal defect, your pediatric cardiologist will want to carefully monitor him or her to make sure the condition is not causing damage to the heart. You will likely have frequent appointments and repeated tests at our Heart Institute to track the condition.

Medication

If your child has symptoms like shortness of breath or trouble nursing, he or she will be given medications to help treat these symptoms and help the heart beat more efficiently. Some VSDs will close on their own, without a surgical procedure.

However, if your child has symptoms despite the medications, or if the hole is large enough that it is unlikely to close on its own, then surgery should be performed to close the hole. Some VSDs should be closed regardless of their size because of their position within the heart wall. 

Heart Surgery

Ventricular septal defects are usually repaired with open-heart surgery by a pediatric cardiac surgeon. In some situations, minimally invasive surgical approaches may be used. This type of surgery is relatively low risk and most children are home within 3-5 days after surgery.

Learn why Children’s Colorado is the best place for your child’s heart surgery.

Signs & Symptoms

What are the signs and symptoms of ventricular septal defects (VSDs)?

A child’s symptoms depend on the size of the hole and where it is located along the septum. Many children seem to have no symptoms. They grow and gain weight normally.

Doctors may be able to tell that a child has VSD while listening to his or her heart during a physical exam. Some VSDs may be identified on a fetal ultrasound exam before a baby is born.

Children with larger, more severe VSD generally have noticeable symptoms as babies. They may have difficulty feeding, which can slow their growth. Children with ventricular septal defects can experience shortness of breath, look pale, fail to gain weight or sweat while eating. Some children have frequent respiratory infections.

Diagnosis & Tests

How do doctors diagnose ventricular septal defects (VSDs)?

Most ventricular septal defects are first identified by a child’s pediatrician during a routine checkup. Blood passing irregularly from the left ventricle to the right causes a “swooshing” sound, also called a murmur, that a doctor can hear while listening to the heart with a stethoscope.

If your doctor suspects your child may have VSD, he or she will request more tests to identify the size and location of the septal hole. Common tests for VSD include:

• Chest x-ray
• EKG
• ECHO

Helpful resources

If you’d like to learn more about VSD, visit:

• The U.S. National Library of Medicine
• The American Heart Association
• Children’s Hospital Colorado Health Library