Patient Education
What is ventricular septal defect?
The heart consists of 4 chambers, the right atrium that receives oxygen-poor blood from the body, the right ventricle that receives blood from the right atrium and pumps it through the pulmonary artery to the lungs to get oxygen; the left atrium that receives oxygen-rich blood from the lungs and left ventricle that receives blood from the left atrium and then pumps it through the aorta to the rest of the body. In ventricular septal defect, there is a hole between the two ventricles that lets blood pass from the left ventricle to the right ventricle. Thus, less amount of blood flows into the aorta and into the body. An extra amount of blood goes into the lungs and the heart has to pump extra to accommodate that extra blood that comes to the left atrium and to maintain regular blood supply to the rest of the body.
What are the symptoms of the ventricular septal defect (VSD)?
In VSD, since more blood goes into the lungs, the lungs have to work more and thus child may have breathlessness. Since more blood comes into the left atrium and then the left ventricle, the left atrium and ventricle enlarge. Also since the right ventricle also receives more blood, the right ventricle also enlarges. The child will have an enlarged heart which may not work well. On exertion, breathlessness increases. The body tries to compensate by increasing the pressure in the pulmonary artery (pulmonary hypertension) to decrease the amount of blood entering into the lungs. If the pulmonary pressures become too high, then the blood would flow from the right side of the heart to the left with the mixing of oxygen-poor blood with oxygen-rich blood and causing bluish discoloration of the skin. This is known as Eisenmenger’s complex.
Do all children with VSD develop Eisenmenger’s complex?
No, all children with VSD do not develop Eisenmenger’s complex. It is only those in whom pulmonary pressures are high which is commonly seen with large holes.
What is the treatment of VSD?
If the hole is small, it may not strain the heart and often it may close spontaneously so no treatment may be required. If the hole is larger, then surgery to close the hole is required to prevent heart failure and Eisenmenger’s complex. Till surgery is done, drugs that improve the function of the heart such as furosemide, captopril, or enalapril may be prescribed by your doctor. The most common operation done is placing a patch over the hole.
Why are children with VSD more prone to pneumonia?
In patients with VSD, since the blood supply to the lungs is more, thus there is more fluid in the lungs. This fluid becomes a source for the germs in the air that we breathe in, good breeding ground to grow and infect the lungs and thus Pneumonia.
After surgery, how do patients with VSD do?
The long term outlook is good. However long term follows up with cardiologists is advocated.