Ventricular Septal Defect (VSD)

What is a ventricular septal defect?

A ventricular septal defect (VSD) is a hole in the wall that separates the lower right and left heart chambers (ventricles). It is the most common type of congenital (present from birth) heart condition.

In patients with VSD, oxygen-rich blood passes from the left ventricle and mixes with oxygen-poor blood in the right ventricle. This sends extra blood to the lungs and make them work harder. The larger the hole, the more symptoms it can cause. Some infants may develop difficulty with growth and breathing. Symptomatic VSDs may be able to be managed with medication. If that is not sufficient, surgical repair is recommended. If left untreated, a large VSD can cause pulmonary hypertension, which can lead to lung disease. Rarely, a VSD can lead to an infection in the heart, called bacterial endocarditis.

A cross-country quest for a biventricular repair

Noah and his family left Washington state and headed for Boston in an RV, holding onto a sliver of hope.

Noah poses with a Mario doll.

What are the symptoms of a ventricular septal defect?

The size of the ventricular septal defect (VSD) affects the type of symptoms, severity of symptoms, and the age at which they first occur. Symptoms often occur in infancy and may include:

  • fatigue
  • sweating
  • rapid breathing
  • heavy breathing
  • congested breathing
  • disinterest in feeding, or tiring while feeding
  • poor weight gain

What are the causes of a ventricular septal defect (VSD)?

A VSD occurs during a baby’s development when the opening between the lower two heart chambers does not close properly.

Most ventricular septal defects occur by chance, with no clear reason.

How are ventricular septal defects diagnosed?

Your child’s doctor will perform a complete exam and look for signs of ventricular septal defect (VSD), such as a heart murmur. The location within the chest that the murmur is heard best, as well as the loudness and quality of the murmur, will give your child’s doctor an idea of which, if any, heart problem your child may have.

Your child’s doctor may also run some tests, including:

How do we treat ventricular septal defects?

Small VSDs may not cause symptoms and not need treatment. In some cases, they may also close on their own as your child grows. Larger VSDs may need treatment or surgery.

Treatment options may include:

  • Medications: Certain medications can help the heart and reduce symptoms. For example, digoxin can strengthen the heart muscle, so it’s able to pump more efficiently. Diuretics can help the kidneys remove excess fluid from the body and antibiotics can help prevent bacterial endocarditis (an infection inside the heart).
  • Surgery: If the child continues to have symptoms despite medical and nutritional therapy, the defect can be closed with a surgical patch.
  • Cardiac catheterization: In rare circumstance, a VSD can be closed, or partially closed, with a device delivered by a catheter.

How we care for ventricular septal defects

Most VSDs are small enough that observation or medical therapy, including higher calorie formula or medications to relieve congested breathing, are all that is needed. Many VSDs become smaller on their own and even close. If an infant has significant difficulties with growth or breathing, despite medical therapy, then surgical closure can be performed with excellent results. Our cardiologists can assess patients with VSDs and guide their care through infancy and beyond. We work hand in hand with our cardiac surgeons to offer the best outcomes for our patients.