Ventricular Septal Defect (VSD)

Introduction

Ventricular Septal Defect (VSD) is a congenital heart condition where there is a hole in the septum (the wall) that separates the two lower chambers (ventricles) of the heart. This leads to abnormal blood flow between the left and right ventricles.

Causes and Risk Factors

• Congenital (from birth) : The defect develops during fetal growth
• Genetic Factors : Family history of congenital heart disease increases risk
• Environmental Factors : Maternal infections, drug use, or poor prenatal nutrition may influence development

Symptoms of VSD

Symptoms depend on the size of the defect and can include: - Small VSDs : Often asymptomatic and close on their own - Medium to Large VSDs : - Shortness of breath - Poor weight gain in infants - Fatigue - Heart murmur (abnormal heart sound) - Frequent respiratory infections

Diagnosis

• Echocardiogram (ultrasound of the heart)
• Electrocardiogram (ECG)
• Chest X-ray
• Cardiac MRI (in some cases)
• Cardiac catheterization (for detailed assessment in complex cases)

Treatment Options

• Observation : Small VSDs may close on their own
• Medication : To help manage symptoms (e.g., diuretics to reduce fluid buildup, drugs to control heart strain)
• Surgical Repair : For large or symptomatic VSDs
  • Catheter-based closure (minimally invasive technique)
  • Open-heart surgery (for larger defects)

Potential Complications

• Heart Failure : Due to increased workload on the heart
• Pulmonary Hypertension : Increased pressure in the lungs
• Endocarditis : Infection of the heart lining
• Arrhythmias : Irregular heartbeats

Long-term Outlook

With early detection and proper management, most people with VSD lead normal, healthy lives. Some may require lifelong cardiac monitoring.

Prevention

While congenital heart defects like VSD cannot always be prevented, expecting mothers can reduce the risk by: - Avoiding alcohol and drugs during pregnancy - Controlling diabetes or other chronic conditions - Taking prenatal vitamins (especially folic acid)

Conclusion

Ventricular Septal Defect is a common congenital heart defect with effective treatment options. If diagnosed early, most patients have a good prognosis and can lead full, active lives.

Source recommendations

1. 2020 American Heart Association Guidelines for the Management of Congenital Heart Disease

1. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000603
2. https://www.heart.org/en/health-topics/congenital-heart-defects
3. https://professional.heart.org/en/guidelines-and-statements
4. https://pubmed.ncbi.nlm.nih.gov/33073615/
5. https://www.jacc.org/doi/10.1016/j.jacc.2021.09.010

2. 2021 European Society of Cardiology Guidelines for Adult Congenital Heart Disease

1. https://academic.oup.com/eurheartj/article/42/6/563/5898606
2. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Grown-Up-Congenital-Heart-Disease-Management-of
3. https://pubmed.ncbi.nlm.nih.gov/32860028/
4. https://www.jacc.org/doi/10.1016/j.jacc.2021.09.010
5. https://pubmed.ncbi.nlm.nih.gov/34736567/