Ventricular Septal Defect (VSD): Causes, Symptoms, Diagnosis & Treatment

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 What is Ventricular Septal Defect (VSD)?

Ventricular Septal Defect (VSD) is a congenital heart defect in which there is a hole in the septum (wall) separating the left and right ventricles of the heart. This opening allows oxygen-rich blood from the left ventricle to mix with oxygen-poor blood in the right ventricle.

VSD is one of the most common congenital heart defects, especially in newborns and infants.

How Does VSD Affect the Heart?

Normally, the left side of the heart pumps oxygenated blood to the body, and the right side pumps deoxygenated blood to the lungs.
In VSD:

  • Blood flows from left ventricle → right ventricle (left-to-right shunt)

  • This increases blood flow to the lungs

  • Over time, it can strain the heart and lungs

Types of Ventricular Septal Defect

  1. Perimembranous VSD – Most common; near the heart valves

  2. Muscular VSD – Located in the lower muscular part of the septum

  3. Inlet VSD – Near the tricuspid and mitral valves

  4. Outlet (Subarterial) VSD – Near the pulmonary and aortic valves

Causes of VSD

  • Abnormal heart development during fetal life

  • Genetic factors or chromosomal disorders (e.g., Down syndrome)

  • Maternal infections, diabetes, or alcohol use during pregnancy

  • Often, the exact cause is unknown


Symptoms of VSD

Symptoms depend on the size of the defect.

Small VSD

  • Often asymptomatic

  • Detected by heart murmur

Moderate to Large VSD

  • Rapid breathing

  • Poor feeding and failure to thrive

  • Excessive sweating (especially during feeding)

  • Frequent respiratory infections

  • Fatigue and breathlessness

Diagnosis

VSD is diagnosed using:

  • Physical examination (heart murmur)

  • Echocardiography (2D Echo) – Gold standard

  • Chest X-ray

  • ECG

  • Cardiac catheterization (in selected cases)

Treatment Options

Treatment depends on defect size and symptoms.

1. Observation

  • Small VSDs may close spontaneously

  • Regular follow-up with echocardiography

2. Medical Management

  • Diuretics

  • ACE inhibitors

  • Nutritional support in infants

3. Surgical or Interventional Closure

  • Open-heart surgery

  • Catheter-based device closure (selected cases)

Complications if Untreated

  • Pulmonary hypertension

  • Heart failure

  • Eisenmenger syndrome

  • Growth retardation

  • Infective endocarditis

Prognosis

  • Excellent prognosis with timely diagnosis and treatment

  • Many children lead normal, healthy lives

  • Small VSDs may close naturally within early childhood

Prevention & Parental Guidance

  • Regular antenatal check-ups

  • Avoid alcohol, smoking, and infections during pregnancy

  • Early screening of newborns

  • Follow pediatric cardiologist advice strictly

Conclusion

Ventricular Septal Defect is a common yet highly manageable congenital heart condition. Early diagnosis, proper monitoring, and timely intervention ensure a positive outcome and good quality of life for affected children.

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