Ventricular Septal Defect

A Ventricular Septal Defect (VSD) is a heart condition that develops when there is a hole in the wall (septum) that separates the 2 lower chambers of the heart, called the ventricles. This hole lets blood pass from the left ventricle to the right ventricle, which means oxygen-rich blood mixes with oxygen-poor blood. The heart must work harder to distribute blood throughout the body, & if not addressed, it can result in significant complications.

VSD is one of the most common kinds of congenital heart defects, meaning it’s present at birth. The size of the defect can vary, and so can its effects. Some small VSDs may close on their own as a child grows, while larger ones may require medical intervention, such as surgery.

In this blog, we’ll explore what causes VSD, the symptoms to watch for, how it’s diagnosed, and the treatment options available to manage this health condition effectively. Understanding VSD can help individuals and families make informed decisions about care and treatment for a healthier life.

Ventricular Septal Defect Causes

A Ventricular Septal Defect (VSD) is a condition that develops when a baby’s heart doesn’t form properly during pregnancy. Normally, the heart forms with a solid wall (called the septum) between the left and right ventricles, the two lower chambers of the heart. In babies with VSD, there’s a hole in this wall, letting blood flow between the two chambers. Here’s a breakdown of the key causes of VSD:

1. Congenital (Present at Birth)

Most VSDs occur because of abnormal development during the early weeks of pregnancy. The heart forms in the first 6 to 10 weeks of pregnancy, and if the septum between the ventricles doesn’t close completely, a VSD occurs. Doctors don’t know exactly why this happens, but it’s usually a random occurrence and not due to anything the parents did or didn’t do during pregnancy.

2. Genetic Factors

Sometimes, genetics can play a role. VSD can be part of a broader genetic condition or syndrome, such as Down syndrome, where changes or abnormalities in a baby’s genes affect how the heart and other parts of the body form. If there’s a family history of heart defects, the baby may have a higher chance of developing a VSD.

3. Environmental Factors During Pregnancy

Various environmental factors during pregnancy may increase the risk of a baby being born with a VSD. These can include:

   – Maternal Infections: Certain viral infections, like rubella (German measles), during pregnancy, may affect the development of the baby’s heart.

   – Diabetes: Poorly controlled diabetes in the mother can increase the risk of heart defects, including VSD.

   – Medications or Substance Use: Exposure to certain medications or harmful substances during pregnancy, such as alcohol or drugs, can interfere with normal heart development.

4. Unknown Causes

In many cases, the exact cause of VSD remains unknown. It’s important to remember that VSD is not caused by anything the parents did wrong during pregnancy, and it can happen even in pregnancies where everything seems normal.

While the causes of VSD can vary, the condition mostly develops before birth and is often due to factors beyond anyone’s control. Understanding the potential causes helps parents know that, in most cases, nothing could have been done to prevent it. The important thing is that with proper medical care, many children with VSD can lead healthy lives.

Ventricular Septal Defect Definition

A Ventricular Septal Defect (VSD) is a heart condition where there is a hole in the septum that separates the 2 lower chambers (ventricles) of the heart. The ventricles play a role in blood circulation—the left ventricle transmits oxygenated blood to the body, while the right ventricle sends deoxygenated blood to the lungs. If there is a gap in the septum, blood moves from the left ventricle to the right ventricle, causing an excess of blood to be pumped into the lungs, leading to increased strain on the heart.

Ventricular septal defect (VSD) is a common heart condition present from birth. The size and location of the hole within the septum can vary, affecting the severity of the defect and the need for treatment.

Types Of Ventricular Septal Defects

VSDs can be classified based on their location within the ventricular septum and their size. Here are the main types:

1. Perimembranous VSD

– Location: This type of VSD is located in the upper section of the septum, near the heart valves.

– Description: It’s the most common type of VSD. The hole can vary in size, and depending on its size, it can cause a wide range of effects, from mild to severe.

– Complications: If the hole is large, it may cause significant extra blood flow to the lungs, leading to symptoms like breathlessness and poor weight gain in babies.

2. Muscular VSD

– Location: This type is located in the lower part of the septum, in the muscular portion of the heart.

– Description: Muscular VSDs can have one or multiple small holes, and they tend to close on their own more often than other types. This is because the muscle tissue in the heart can grow and seal the hole naturally as the baby grows.

– Complications: In many cases, this type of VSD is less serious & may not require surgery if the holes are small and close on their own.

3. Inlet VSD (Atrioventricular Canal Type)

– Location: Found near the valves that control blood flow between the upper & lower chambers of the heart (tricuspid and mitral valves).

– Description: This type of VSD is located lower in the septum and can sometimes be associated with other heart abnormalities, like a defect in the heart’s valves.

– Complications: This type may require surgery, especially if it’s part of a more complex heart problem.

4. Outlet VSD (Supracristal VSD)

– Location: This type is found in the upper part of the septum, near where blood leaves the heart through the arteries (aorta and pulmonary artery).

– Description: Outlet VSDs are less common and can be more serious because they are located close to the heart’s valves, which can be affected over time.

Complications: This type of VSD may require surgical repair because the extra blood flow can damage the valves.

5. Multiple Ventricular Septal Defects

– Description: Some people may have more than one VSD, with multiple holes in the septum. This condition can make the heart work harder to pump blood, leading to more severe symptoms.

– Complications: Treatment often involves surgery, especially if the holes are large or numerous, to prevent heart failure or damage to the lungs.

The type of Ventricular Septal Defect a person has depends on the location and size of the hole in the septum. Some types, like muscular VSDs, may close on their own and require minimal intervention, while others, like perimembranous and outlet VSDs, may require surgery to correct the problem. Understanding the different types of VSD is important for determining the right course of treatment and ensuring that the heart can function properly.

Ventricular Septal Defect Treatment

When treatment is required, the options range from non-surgical to surgical interventions. Medications like diuretics and digoxin may be prescribed to manage symptoms of VSD, such as shortness of breath or issues related to heart function. Additionally, supplemental feeding might be recommended to ensure proper growth and strength, especially in infants.

Surgical repair is considered for larger or symptomatic VSDs. Traditional open-heart surgery is one method where an incision is made in the chest to access the heart and close the defect with sutures or a patch. Minimally invasive techniques, like robotic-assisted surgery or video-assisted thoracoscopic surgery (VATS), are also available. These methods involve smaller incisions, which can lead to reduced recovery time and fewer complications.

Another less invasive option is catheter-based closure, also known as angioplasty. This medical procedure involves inserting a catheter into a blood vessel, guiding it to the heart, and then using a device to close the VSD. This method is suitable for certain types of VSDs and is monitored using imaging techniques to ensure correct placement and closure of the defect.

The cost of VSD treatment in India starts from approximately INR 2,00,000 and can go up to INR 7,00,000, depending on the complexity of the case, the chosen treatment method, and the hospital where the treatment is performed. For instance, transcatheter VSD closure surgery may cost between INR 2.5 lakh to INR 3 lakh.

Ventricular Septal Defect Symptoms

A Ventricular Septal Defect (VSD) can cause a variety of symptoms based on the size of the hole in the heart and how much blood is flowing through it. Some small VSDs may not cause any symptoms at all, and people may live their whole lives without knowing they have the condition. However, larger VSDs can lead to noticeable symptoms, especially in babies and young children.

1. Shortness of Breath

– What Happens: A VSD causes more blood to flow into the lungs. This extra blood puts pressure on the lungs, making it harder for them to work properly.

– Symptoms in Babies: Babies with VSD may breathe quickly or seem to have difficulty breathing, especially when feeding or crying. You may notice that they breathe faster than usual, even when they are resting.

– Symptoms in Older Children/Adults: As children grow older, they may feel out of breath more easily when playing or exercising.

2. Poor Weight Gain

– What Happens: Babies with a VSD may have trouble gaining weight because their heart is working hard to pump blood, using up more energy.

– Symptoms in Babies: You might notice that your baby gets tired easily while feeding, stops feeding early, or takes longer to feed. This can result in slower weight gain or failure to thrive compared to other babies.

3. Fatigue

– What Happens: Since the heart is working overtime to pump extra blood to the lungs, children with a VSD may feel more tired than usual.

– Symptoms in Children/Adults: As children grow, they may have less energy and tyre easily during physical activities or exercise. Older children and adults with a larger VSD may feel unusually tired, even when doing everyday tasks.

4. Heart Murmur

– What Happens: A heart murmur is an unusual “whooshing” sound heard when a doctor listens to the heart with a stethoscope. This sound is caused by the extra blood flowing through the hole in the heart.

– Symptoms in All Ages: Often, a VSD is detected when a doctor hears this murmur during a routine check-up. Even if there are no other symptoms, the murmur can be a sign that blood is flowing abnormally between the heart’s ventricles.

5. Frequent Respiratory Infections

– What Happens: The extra blood flow to the lungs makes them more susceptible to infections like pneumonia or bronchitis.

– Symptoms in Babies and Young Children: Babies with VSD may have frequent colds, coughs, or lung infections. These infections can be more severe or take longer to clear up.

6. Sweating During Feeding or Activity

– What Happens: Since the heart has to work harder to pump blood, babies may sweat more than usual, even when they’re not very active.

– Symptoms in Babies: Parents often notice that their baby sweats a lot while feeding or sleeping. This can be a sign that the heart is under strain.

– Symptoms in Older Children/Adults: In older children or adults, excessive sweating may happen during mild activities or exercise.

7. Swelling (Edema)

– What Happens: In more severe cases, if the heart struggles to keep up with the extra blood flow, fluid can build up in the body.

– Symptoms in Severe Cases: You may notice swelling in the legs, feet, abdomen, or around the eyes. This is called edema and is a sign that the heart is not pumping blood properly.

8. Rapid Heartbeat (Tachycardia)

– What Happens: The heart may beat faster than normal to keep up with the extra workload.

– Symptoms in Babies and Adults: A rapid heartbeat can be felt as a fast or irregular pulse, especially after physical activity or when the body is under stress.

Ventricular Septal Defect Diagnosis

Doctors diagnose a Ventricular Septal Defect (VSD) using the following methods:

1. Physical Exam: A doctor listens for a “heart murmur” with a stethoscope, often the first sign of VSD.

2. Echocardiogram (Echo): This ultrasound creates a picture of the heart to show the size and location of the VSD and how much blood is flowing through it.

3. Electrocardiogram (ECG/EKG): This measures the heart’s electrical activity to determine whether it’s working harder due to the VSD.

4. Chest X-ray: This shows if the heart is enlarged or if extra blood is flowing to the lungs.

5. Cardiac Catheterization (less common): Provides detailed information about blood flow and heart pressure.

Risk Factors For Ventricular Septal Defect

Various factors can increase the possibility of a baby being born with a Ventricular Septal Defect (VSD):

1. Genetics: A family history of heart defects or conditions like Down syndrome increases the risk.

2. Maternal Health: Uncontrolled diabetes or viral infections (like rubella) during pregnancy can affect the baby’s heart development.

3. Medications: Certain medications taken during pregnancy can increase the risk of heart defects.

4. Alcohol or Drug Use: Using alcohol or illegal drugs during pregnancy raises the chances of VSD.

5. Maternal Age: Women over 35 may have a higher risk of having a baby with VSD.

Conclusion

Ventricular Septal Defect (VSD) is a common heart condition where a hole in the heart affects blood flow, causing symptoms like shortness of breath and poor growth in children. While some VSDs may heal on their own, others require medical treatment or surgery, which can be costly. In India, treatment for VSD can place a financial burden on families.

A fundraising platform can be a valuable way to help cover these expenses. By raising funds through donations from friends, family, and even strangers, families can get the financial support they need for surgeries, hospital stays, and ongoing care. Platforms like these make it easier for families to manage the cost of treatment and ensure their loved ones receive the finest care they need.