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.