Ventricular Septal Defects (VSDs) are common heart problems since birth, causing a hole in the heart’s wall. This issue affects how blood moves between the heart’s parts, impacting oxygen distribution in the body. VSDs are the top congenital heart problem globally, affecting many newborns every year. Thankfully, most cases are found early and treated without many issues.

Knowing the ways to treat VSDs is crucial. Treatments vary from medicines to surgeries and aim to fix symptoms and reduce complications linked to different VSD sizes. This guide explains VSDs in simple terms, covering what causes them, their signs, tests to detect them, treatment options, costs involved, and answers to common questions. It’s a helpful overview for anyone dealing with this common heart issue.

What Is a Ventricular Septal Defect?

A ventricular septal defect (VSD) — sometimes referred to as a hole in the heart — is a type of congenital heart defect. A VSD has an abnormal opening in the wall between the heart’s main pumping chambers (the ventricles).

VSDs are the most common congenital heart defect. Most VSDs are diagnosed and treated successfully with few or no complications.

What Happens in a Ventricular Septal Defect?

The heart’s right and left ventricles are separated by a shared wall called the ventricular septum. Children with a VSD have an opening in this wall. As a result:

• When the heart beats, some of the blood in the left ventricle (enriched by oxygen from the lungs) flows through the hole in the septum into the right ventricle.
• In the right ventricle, this oxygen-rich blood mixes with the oxygen-poor blood and returns to the lungs.
• The blood flowing through the hole creates an extra noise known as a heart murmur. Doctors can hear the heart murmur when they listen to the heart with a stethoscope.

What Causes a Ventricular Septal Defect?

Ventricular septal defects happen as a baby’s heart develops before birth. The heart develops from a large tube, dividing into sections that eventually become the walls and chambers. A hole can form in the ventricular septum if there’s a problem during this process.

In some cases, the tendency to develop a VSD may be due to genetic syndromes that cause extra or missing pieces of chromosomes. Most VSDs, though, have no apparent cause.

What Are the Signs & Symptoms of a Ventricular Septal Defect?

Whether a VSD causes any symptoms depends on the size of the hole and its location. Small VSDs usually won’t cause symptoms and might close on their own.

Older kids or teens who have small VSDs that don’t close usually have no symptoms other than a heart murmur. They might need to see a doctor regularly to ensure the VSD isn’t causing problems.

Medium and large VSDs may cause noticeable symptoms. Babies may have faster breathing and get tired when they try to feed. They may start sweating or crying while feeding and may gain weight slowly.

These signs generally indicate that the VSD will not close by itself, and the child may need heart surgery. Usually, this is done in the baby’s first three months of life to prevent other problems. A cardiologist can prescribe medicine to lessen symptoms before the baby has surgery.

What Problems Can Happen?

Infants with a large VSD can develop heart failure and have feeding problems that lead to poor weight gain. They also may get chest infections often. Children with a small VSD are at risk for developing endocarditis, an infection of the inner surface of the heart caused by bacteria in the bloodstream. Bacteria are always in our mouths; small amounts get into the bloodstream when we chew and brush our teeth.

Dr. Mittal says, “Good dental hygiene to reduce oral bacteria is the best way to protect the heart from endocarditis. Kids should brush and floss daily and see their dentist regularly. Patients with simple VSDs don’t need antibiotics before dental visits, except for the first six months after VSD surgery.”

How Are Ventricular Septal Defects Diagnosed?

Doctors usually find a VSD in a baby’s first few weeks of life during a routine checkup. They’ll hear the heart murmur, which has certain features that let them know it’s not caused by something else.

If your child has a heart murmur, the doctor may refer you to a pediatric cardiologist (a doctor who diagnoses and treats childhood heart conditions).

The cardiologist will do an exam and take your child’s medical history. Suppose the doctor thinks there’s a VSD. In that case, they may order tests such as:

• A chest X-ray: a picture of the heart and surrounding organs
• An electrocardiogram (EKG): a record of the heart’s electrical activity
• An echocardiogram: an ultrasound of the heart. Often, this is the primary way doctors diagnose a VSD.
• A cardiac catheterization: this provides information about the heart’s structures and the blood pressure and blood oxygen levels in its chambers. This test is usually done for a VSD only when more information is needed than the other tests can give. (It’s sometimes also used to close certain kinds of VSDs.)

What are the Treatment Options for VSD?

Ventricular septal defect treatment may include regular health checkups, medications, and surgery. Many babies born with a minor ventricular septal defect (VSD) won’t need surgery to close the hole. Some small VSDs close on their own.

“If the VSD is small, regular health checkups may be all that’s needed. Medication may be prescribed to treat any symptoms,” – says Dr. Mittal.

a) Medications

Medications won’t repair a ventricular septal defect, but they may be given to treat symptoms or complications. The specific medications used depend on the symptoms and their cause. Water pills (diuretics) decrease the body’s fluid and reduce the strain on the heart.

b) Surgeries or other procedures

Surgery may be done if the VSD is medium or large or if it’s causing severe symptoms. Babies who need surgery to repair the hole often have the procedure in their first year.

A surgeon may close minor ventricular septal defects if their location in the heart could cause damage to nearby structures, such as the heart valves.

Surgeries and procedures to repair a ventricular septal defect include:

• Open-heart surgery: This is the preferred procedure for repairing most ventricular septal defects. A surgeon uses a patch or stitches to close the hole between the lower heart chambers. This type of VSD surgery requires a heart-lung machine and an incision in the chest.
• Catheter procedure: Some ventricular septal defects can be repaired using thin, flexible tubes (catheters) without open-heart surgery. The health care provider inserts a catheter into a blood vessel, usually in the groin, and guides it to the heart. A small device is inserted through the catheter to close the hole.

“After ventricular septal defect surgery, regular checkups are needed for life. Checkups often include imaging tests to determine how healthy the surgery is working,” – advises Dt. Mittal.

Rajat Mor praised Dr. Dinesh Kumar Mittal, a highly qualified and kind-hearted doctor. Rajat says, “Dr. Mittal successfully performed open-heart surgery on my father, showcasing his brilliance. I sincerely thank Dr. Mittal for his expertise and care during the procedure. His excellent skills and compassionate nature made the surgery a success, ensuring my father’s well-being. I’m sincerely thankful for Dr. Mittal’s remarkable efforts and professionalism throughout the process.”

What Is the Cost Of VSD Treatment in Delhi?

In Delhi, the average cost for VSD surgery for Indian patients is approximately Rs. 2,60,000, with prices typically starting around Rs. 1,90,000 and reaching up to Rs. 4,00,000.  The cost for International patients is between USD 2340 and USD 2860.

However, it’s essential to note that these figures may vary significantly based on factors such as hospital facilities, the surgeon’s expertise, the severity of the condition, additional medical expenses, and post-operative care. Hence, the final cost may vary depending on individual cases and specific hospital charges.

Conclusion

Ventricular septal defects (VSDs) treatment options vary based on the defect’s size, symptoms, and associated risks. While small VSDs might close on their own or require monitoring with regular checkups, more significant defects often necessitate medications or surgical interventions. Thanks to medical advancements, surgeries are performed successfully, either through open-heart procedures or minimally invasive catheter-based techniques. However, post-operative care and lifelong follow-ups remain crucial to ensure the effectiveness of the treatment and monitor the heart health of individuals affected by VSDs.

FAQs

1. Can a Ventricular Septal Defect (VSD) be Prevented?

Preventing VSDs entirely is challenging since they are often present at birth and result from developmental issues in the heart’s structure.

2. Do all Ventricular Septal Defects Require Surgery?

No, not all VSDs need surgical intervention. Minor defects might close on their own or may not cause significant issues.

3. Can Adults Have Ventricular Septal Defects?

Yes, although VSDs are typically diagnosed in childhood, some minor defects might remain undetected until adulthood, causing minimal or no symptoms.

4. Are VSDs Always Diagnosed at Birth?

Not always. Some VSDs, especially smaller ones, might not produce noticeable symptoms or a heart murmur, leading to a later diagnosis.

5. Can Lifestyle Changes Help Manage Ventricular Septal Defects?

While lifestyle changes may not directly close a VSD, maintaining a healthy lifestyle with proper nutrition and regular exercise can support overall heart health, aiding in symptom management and well-being.