Ventricular Septal Defect (VSD) in children

Ventricular Septal Defect (VSD) is a congenital heart defect characterized by one or more holes in the ventricular septum, the wall separating the heart’s two lower chambers (ventricles). This defect allows oxygen-rich blood from the left ventricle to mix with oxygen-poor blood in the right ventricle. Here’s an overview of VSD in children:

Types of VSD

Perimembranous VSD:
- Most common type, located near the heart’s valves.
Muscular VSD:
- Found in the lower part of the septum, may be single or multiple.
Inlet VSD:
- Occurs near the valves that bring blood into the ventricles.
Outlet (Conal or Supracristal) VSD:
- Located near the valves that lead out of the ventricles.

Symptoms

Small VSDs often cause no symptoms and may close on their own.
Moderate to large VSDs can cause:
- Shortness of breath
- Fast breathing or breathlessness
- Frequent respiratory infections
- Poor feeding and growth (in infants)
- Fatigue and rapid heartbeat

Diagnosis

Echocardiogram: Key diagnostic tool, uses ultrasound waves to create images of the heart.
Electrocardiogram (ECG/EKG): Records the electrical activity of the heart.
Chest X-ray: Checks the size and shape of the heart and lungs.
Cardiac Catheterization: Sometimes used to measure oxygen levels and pressure in the heart chambers.

Treatment

Observation: Small VSDs may close spontaneously and are often monitored.
Medications: Can help manage symptoms but do not close the VSD.
Surgical Repair: Necessary for large VSDs or those causing significant symptoms or complications.
Catheter-Based Procedures: Less invasive option for some types of VSDs.

Prognosis

Children with small VSDs generally have an excellent prognosis and often require no treatment other than observation.
Surgical closure of larger VSDs is usually successful and improves the long-term outlook.
Regular follow-up care is important for monitoring heart health.

Complications if Untreated

Heart failure
Pulmonary hypertension (high blood pressure in the lung arteries)
Growth and developmental delays in children
Increased risk of endocarditis (infection of the heart lining)

Prevention and Monitoring

While VSDs can’t be prevented, good prenatal care can help identify potential heart issues early.
Children with a family history of heart defects may benefit from genetic counseling.
Regular cardiac check-ups are crucial for children with VSD to monitor their heart health and development.

Management of a VSD depends on its size, location, and the severity of the symptoms it causes. Collaboration with a pediatric cardiologist is crucial for the optimal care and management of children with VSD.