A Ventricular Septal Defect (VSD) is often referred to as a hole in the heart. This condition may generally occur at the time of birth. In this congenital defect, the wall or the septum dividing the lower chambers of the heart, the ventricles, is not completely formed, leaving a gap or a hole. This hole allows some of the blood from the left ventricle to pass into the right side of the heart. The left ventricle, in fact, has oxygen-rich blood that must be supplied to the rest of the body. However, due to this hole, it gets pumped back to the lungs making the heart work harder to pump this extra blood all over again.
A small ventricular septal defect may cause no problems, and many small VSDs close on their own. Medium or large VSDs may need surgical repair early in life to prevent complications.
A ventricular septal defect (VSD) is generally a condition since birth. Genetic or inherited diseases such as Down's syndrome is also associated with ventricular septal defect (VSD). There are certain diseases that pregnant women could be exposed to, which can be a cause for ventricular septal defect (VSD) in the unborn children. Other reasons could include some prescription medications, rubella (German measles) and/or uncontrolled diabetes.
Symptoms of Ventricular Septal Defect (VSD)
The most common symptoms of the ventricular septal defect (VSD) are as follows:
- Getting short of breath especially while exercising
- Exhaustion/ tiredness
- Cyanosis (a blue tint on the lips, skin, or fingernails caused by a lack of oxygen)
- Murmuring of the heart
- Abnormality in the rhythms of the heart. Also known as arrhythmias
- Extremities getting swollen
There is a possibility that most of the above-mentioned symptoms can be misinterpreted to be some other disease altogether. It could be perceived that it is some sort of lung disorder or the generic signs of aging or physical inactivity.
Treatment of Ventricular Septal Defect (VSD)
There are a variety of procedures that can be followed to treat or manage ventricular septal defect (VSD), depending upon its severity.
Certain minor congenital heart defects found in adults will not require any treatment as such. However, these patients must enrol themselves for regular heart check-ups to ensure that the defect is not getting more severe over time.
Medicines can be used to treat some minor septal defects in order to help the heart work better. These drugs are given to achieve the following results:
- Lower the pace of a heartbeat (beta-blockers)
- Relax the blood vessels (calcium channel blockers)
- Prevention of blood clots such as warfarin
- Discharge excessive fluids from the body (diuretics)
Not all drugs can have the same response for all types of ventricular septal defects. There is a possibility that some drugs that are useful in treating a specific type of septal defect can make another type of septal defect worse.
Patients suffering from ventricular septal defect (VSD) are always at a risk of infection, known as endocarditis. This is still possible even if their defect has been completely cured.
Surgery for Correction of VSD
Before the heart surgery
Certain pre-operative tests will be conducted before the surgery. These tests will include:
- Physical examination: The doctor will conduct some physical tests to determine whether you are fit to undergo surgery or not
- Blood tests: Blood tests will determine the normal functioning of the other organs. Also, it will help the doctor know the blood group of the patient and whether blood transfusions will be required during surgery or not
- Chest x-ray: The X-ray will reveal the condition, shape and size of the heart
- Electrocardiogram: Electrocardiogram determines the rhythm of the heartbeat
Patients will be needed to take antibiotics before any other surgical procedure to reduce the risk of infection. Hours before the surgery, the patient will be asked not to eat or drink anything, to bathe and shave any hair off from the area where the surgery will be performed. The special dress will be provided to the patient by the medical staff to wear during the surgery.
Test and Diagnosis for VSD
The most commonly initiated tests to diagnose the possibility of the ventricular septal defect (VSD) include:
- Echocardiogram: This test is performed to determine the anatomical structure of the heart, the volume of blood pumped by the heart and its pressures
- Electrocardiogram: This test monitors any problems with the heart rhythm
- Chest X-rays: Chest X-ray shows the size and shape of the heart
- Coronary catheterization: This test identifies the blocked blood vessels
- Magnetic resonance imaging (MRI): MRI takes a detailed picture of the heart's chambers and blood vessels
- Stress (exercise) testing: This test measures the functioning accuracy of the heart under stressful conditions
During the Surgery
The VSD correction surgery is performed by two methods
- Intra-cardiac Technique: This is the most commonly used method for treating VSD in children. It is an open heart surgery performed when the patient is put in a heart-lung machine or the cardiopulmonary bypass. During this process, the surgeon sews a patch of fabric or a part of the pericardium present outside the heart over the VSD. This helps to close the VSD completely, and in the course of time, the patch is covered by normal tissue and recovers completely.
- Catheter Intervention: In this type of surgery, it is performed through a catheter- a tube that is run through the blood vessels directly into the heart. Catheter techniques are best suited for minor or small septal defects and some defective valves.
After the heart surgery
After the successful completion of the surgery, the patient with repaired VSDs must visit a cardiologist for regular check-ups. On the contrary, those patients who develop other congenital problems or have any cardiac complications after the surgery should continue to see an adult congenital heart disease specialist.