Ventricular Septal Defect

Ventricular septal defect is a birth defect where the child is born with a hole in the wall separating the lower chambers of the heart. This is a congenital defect that a child is born with.

A human heart has four chambers—two upper and two lower—that pump blood in and out of the heart. While the left side of the heart pumps blood to and from the body, the right side pumps blood to and from the lungs only. Atria are the upper chambers of the heart and ventricles are the lower chambers.

Sometimes, children are born with a hole in the wall of the left and right ventricles. This allows blood to leak from the left ventricle to the right ventricle. This increases the pressure on the right side of the heart which now has to pump more blood. In some cases, if the hole is large, the blood may flow into the lungs causing undue tension on the lungs as well.

What is ventricular septal defect?

In some babies, the ventricular wall or septum is not fully developed by the time they are born. This leaves an opening between the left and right ventricles.

This opening or hole allows blood to flow from the left lower heart chamber to the right lower heart chamber. If the opening is small, symptoms may be mild or even negligible.

However, if the opening is wide, the additional blood flow into the right ventricle leads to swelling in the right of the heart. It may also lead to tension in the lungs causing shortness of breath.

Causes of ventricular septal defect

The causes of atrial septal defect are not known. Since it is a congenital issue, sometimes genes can be responsible for the defect. However, in some rare cases, a ventricular septal defect may also occur later in life. This usually happens after a heart attack or after a heart procedure.

Sometimes ventricular septal defect may run in the family. If you have a history of the defect in the family, seek guidance from your doctor before you plan your pregnancy.

To find out more about heart defects, click here.

Symptoms

In most cases, symptoms of a ventricular septal defect may be detected within the first few weeks of the child’s birth. Ventricular septal defect symptoms are similar to those of any other heart defects:

• Shortness of breath
• Fatigue and tiredness
• Poor diet
• A gentle murmur that can be picked up through a stethoscope

If the defect is small, the symptoms may not show until adulthood. In some cases, people with ventricular septal disease may not even show any symptom at all.

Diagnosis

Unlike the an atrial septal defect, which can be diagnosed during pregnancy, ventricular septal defects are detected only after the child is born. If the baby has any of the above symptoms, the doctor can detect the defect by picking up a murmur in the heart through a stethoscope.

Depending on the severity of the symptoms, the doctor may prescribe an ultrasound of the heart, also known as the echocardiogram. Sometimes, the symptoms do not show up until the baby has grown into an adult, in which case an echocardiogram may be used to detect the defect.

Types of ventricular septal defects

Primarily there are four types of atrial septal defects:

Conoventricular Ventricular Septal Defect: A hole where portions of the lower wall should meet below the pulmonary and aortic valve is known as the Conoventricular Ventricular Septal Defect.

Perimembranous Ventricular Septal Defect: This defect occurs when there is a hole in the top section of the ventricular wall.

Inlet Ventricular Septal Defect: This defect occurs when there is a hole in the wall near to the point where blood enters the lower chambers.

Muscular Ventricular Septal Defect: In this case, which is the most commonly recorded type of ventricular septal defect, the hole is situated in the lower section of the ventricular wall.

Complications from ventricular septal defect

If the hole in the septum is not too big, the symptoms may be insignificant. There may not be any severe complications.

However, if the defect is large, it can lead to a range of complications. Excessive pressure on the right ventricle can lead to heart failure. If the blood leaks into the lungs, it can lead to pulmonary hypertension and cause permanent damage to the lungs. Another complication of ventricular septal defect is the chance of a bacterial infection along the walls of the heart. This is known as endocarditis and is not very common. 

Treatment

Sometimes in babies, if the ventricular septal defect is small, it may close on its own with time. If it doesn’t close on its own but also doesn’t have severe symptoms, you may not necessarily require treatment. Your doctor may monitor the defect regularly to check on the size of the defect and its symptoms.

Ventricular septal defect treatment depends on the extent of the damage, the age of the patient as well as the symptoms.

One of the symptoms of ventricular septal defect is that the baby or child grows tired while feeding. This could lead to malnourishment and the doctor may, therefore, prescribe a high-calorie formula. Some children are also prescribed medication that strengthens their heart muscles and lowers their blood pressure.

If the symptoms are severe among, ventricular septal defect treatment entails closing the opening in the septum. This can be done either using a catheter and placing a device to shut the wall or with an open heart surgery to repair the wall. While catheterisation is a minimally-invasive surgery, an open heart surgery is major procedure.

Following the treatment, your doctor will continue monitoring the situation with regular check-ups to see that the wall remains shut.

Conclusion

In many cases, ventricular septal defects go completely unnoticed as people with the defect do not show any symptoms. In others, the symptoms may be mild.

However, a ventricular septal defect should not be taken lightly. If you or your child are showing symptoms of breathlessness or fatigue, it is a good idea to get a doctor’s appointment at the earliest.

Although, there is little reason to worry, especially if the defect is diagnosed in time. There are medications available to manage the condition better. Treatment may also include a minor or major surgical procedure. That doesn’t mean that a ventricular septal defect will affect you in your daily life and restrict your activity. With the right treatment, you and your child can live a full life despite a ventricular septal defect.