Children's Hospital Colorado

Ventricular Septal Defect (VSD)

What is a ventricular septal defect?

If your child has a ventricular septal defect (VSD), 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 "a 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.

Ventricular septal defects in infants are 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.

VSD in infants is one of the most common forms of congenital heart defects and it may occur by itself or with other birth defects. The condition is usually diagnosed in infancy.

What are the signs and symptoms of ventricular septal defect in children?

In babies with a ventricular septal defect (VSD), blood can pass through the hole from the left to the right side of the heart. Before birth, babies with a VSD often remain very stable. However, after birth, a VSD makes the heart less efficient and causes it to work harder.

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 find ventricular septal defect symptoms when listening to a child's heart during a physical exam. Some ventricular septal defects may be identified on a fetal ultrasound exam before a baby is born.

Children with larger, more severe ventricular septal defects generally have noticeable symptoms as babies. They may have difficulty feeding which can slow their growth.

Other ventricular septal defect signs include:

  • Shortness of breath
  • Pale skin
  • Difficulty gaining weight
  • Sweating while eating
  • Frequent respiratory infections in some cases

How do doctors diagnose ventricular septal defects?

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:

What are the options for VSD treatment at Children's Hospital Colorado?

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.


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 too large to close on its own, surgery should be performed to close it. Some VSDs should be closed regardless of their size because of their position within the heart wall.

Heart surgery

A small VSD may cause no problems and many may close on their own.

However, babies born with larger VSDs often need surgical repair in the first few months of life to prevent long-term complications. In this case, 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.

See why our outcomes make us one of the top heart hospitals

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

Related departments

Children's Colorado in the news


Minimally invasive procedure fixes hole in baby’s heart

June 18, 2019

About half of children with Down syndrome have congenital heart disease. At other hospitals, Charlie Smith would have needed open heart surgery to repair her heart. But at Children’s Colorado, Gareth Morgan, MD, repaired Charlie’s heart defect through a minimally invasive procedure called heart catheterization.