Ventricular Septal Defect, Pediatric
Ventricular Septal Defect, Pediatric

Ventricular Septal Defect, Pediatric

A ventricular septal defect (VSD) is a hole in the wall (septum) between the bottom chambers of the heart (ventricles). This is a problem that is present at birth (congenital heart defect). A VSD can change the normal flow of blood in the body.
A VSD is often found during a routine exam in the first few months of a child's life. Your child may or may not have symptoms, depending on the size and location of the hole. Small VSDs may not cause symptoms and may go away on their own. Some larger VSDs may require treatment.

What are the causes?

The cause of this condition is not known.

What increases the risk?

This condition is more likely to develop in:
  • Children with a family history of congenital heart defects.
  • Children with certain genetic conditions, such as Down syndrome.

What are the signs or symptoms?

Signs and symptoms of VSD depend on the size of the hole. Small VSDs often do not cause problems. The only symptom may be an abnormal sound (murmur) that your child's health care provider hears when listening to your child's heart. Moderate and large VSDs may cause symptoms that start several weeks after birth. Symptoms may include:
  • Shortness of breath.
  • Excess sweating, especially during feeding or eating.
  • Poor appetite.
  • Tiring easily during exercise.
  • Trouble gaining weight.
  • Rapid breathing.
  • Blue skin color.

How is this diagnosed?

This condition may be diagnosed based on:
  • A physical exam.
  • Chest X-ray.
  • Electrocardiogram (ECG). This test records the electrical activity of the heart.
  • Echocardiogram. This test uses sound waves to create an image of the heart.
  • Cardiac catheterization. During this procedure, a flexible tube (catheter) is inserted into a blood vessel and guided into the heart. This procedure provides information about the heart structures as well as blood pressure and oxygen levels within the heart chambers.

How is this treated?

Treatment for this condition depends on your child's age and the size and location of the VSD. Many VSDs will close on their by age 2 without treatment. Others may stay the same.
  • If your child has a small VSD that causes no symptoms:
    • Your child will need to have regular checkups with a health care provider to make sure there are no problems.
    • There will usually be no activity limitations.
  • If your child has symptoms of a VSD, but there is a chance that the VSD may close, your child may need to take medicines that strengthen the heart and help control blood pressure. Your child may take these medicines until the VSD closes or surgery becomes necessary.
  • If your child has a medium or large VSD, surgery may be needed to close the hole.
    • This surgery is usually done before age 2. In some cases, it may be done during adolescence.
    • Children who have surgery for a VSD may need to take antibiotic medicine for 6 months after the procedure. This is to protect against an infection of the inner surface of the heart (infective endocarditis).

Follow these instructions at home:

Medicines

  • Give your child over-the-counter and prescription medicines only as told by the health care provider.
  • If your child was prescribed an antibiotic medicine, give it to him or her as told by the health care provider. Do not stop giving the antibiotic even if your child starts to feel better.
  • Do not give your child aspirin because of the association with Reye syndrome.

Dental care

  • Make sure your child gets regular dental care and brushes and flosses regularly. This will help reduce the risk for infective endocarditis.
  • Some children with VSDs or repaired VSDs need to take antibiotics before having dental work or other surgical procedures. These medicines help prevent infective endocarditis. Be sure to tell your child's health care providers, including the dentist if your child:
    • Has a VSD.
    • Has a repaired VSD.
    • Has had infective endocarditis in the past.
    • Has an artificial (prosthetic) heart valve.

General instructions

  • Have your child avoid body piercings. Piercings increase the chance that bacteria can get into the body and cause infective endocarditis. If your child has a heart defect and wants a piercing, talk with your child's health care provider first.
  • If your child has trouble gaining weight, ask the health care provider if your child needs calorie-boosting supplements.
  • Your child may need to work with a heart specialist (pediatric cardiologist). Ask your child's health care provider if this is necessary.
  • Keep all follow-up visits as told by your child's health care provider. This is important.

Contact a health care provider if:

  • Your child has a fever.
  • Your child is eating poorly.
  • Your child has trouble gaining weight.
  • Your child has sudden weight gain.
  • Your child's symptoms change or your child has new symptoms.

Get help right away if:

  • Your child has shortness of breath.
  • Your child who is younger than 3 months has a fever of 100°F (38°C) or higher.
  • Your child is pale, cold, or clammy.
  • Your child's lips or fingers are bluish in color.

Summary

  • A ventricular septal defect (VSD) is a hole in the wall (septum) between the bottom chambers of the heart (ventricles). This is a problem that is present at birth (congenital heart defect).
  • Signs and symptoms of VSD depend on the size of the hole. Small VSDs often do not cause problems.
  • If your child has a medium or large VSD, surgery may be needed to close the hole.
  • Be sure to tell your child's health care providers, including the dentist if your child has a VSD.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.