Ventricular Septal Defect in Children

Ventricular Septal Defect in Children
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What is it?

VSD is a hole in the wall separating the two lower chambers of the heart.

In typical development, the wall in between the chambers closes before the fetus is born, so that by birth, oxygen-rich blood is avoided blending with the oxygen-poor blood. When the hole does not close, it might cause higher pressure in the heart or lowered oxygen to the body.

A ventricular septal defect (VSD)– sometimes referred to as a hole in the heart– is a type of congenital heart defect. In a VSD, there is an unusual opening in the dividing wall between the main pumping chambers of the heart (the ventricles).

Ventricular Septal Defect in Children

What causes it?

In many children, the cause isn’t really understood. It’s a very common kind of heart problem. Some children can have other heart flaws together with VSD.

How does it impact the heart?

Normally, the left side of the heart just pumps blood to the body, and the heart’s right side just pumps blood to the lungs. In a child with VSD, blood can take a trip throughout the hole from the left pumping chamber (left ventricle) to the right pumping chamber (right ventricle) and out into the lung arteries. If the VSD is big, the additional blood being pumped into the lung arteries makes the heart and lungs work harder and the lungs can end up being congested.

How does the VSD impact my child?

If the opening is small, it will not cause symptoms because the heart and lungs do not have to work harder. The only unusual finding is a loud murmur (sound heard with a stethoscope).

If the opening is big, the child may breathe faster and harder than typical. Babies may have difficulty feeding and growing at a normal rate. Symptoms may not take place up until several weeks after birth. High pressure might happen in the blood vessels in the lungs due to the fact that more blood than normal is being pumped there. With time this may cause irreversible damage to the lung blood vessels.

What can be done about the VSD?

If the opening is little, it won’t make the heart and lungs work harder. Surgery and other treatments might not be required. Little VSDs often close on their own. There isn’t really any medicine or other treatment that will make the VSD get smaller or close any faster than it may do naturally.

If the opening is large, open-heart surgery may be had to close it and avoid severe issues. Babies with VSD may develop severe symptoms and early repair, within the first few months, is frequently required. The repair work may be postponed in other babies. Medicines might be used temporarily to help with symptoms, however they don’t treat the VSD or prevent permanent damage to the lung arteries.
Closing a large VSD by open-heart surgery generally is done in infancy or childhood even in patients with couple of symptoms, to avoid complications later. Usually a spot of material or pericardium (the regular lining around the beyond the heart) is stitched over the VSD to close it entirely. Later on this spot is covered by the regular heart lining tissue and ends up being a permanent part of the heart. Some defects can be stitched closed without a patch. It might be possible to close some VSDs in the cath lab.

If a baby is very ill, or has more than one VSD or a VSD in an uncommon area, a temporary operation to ease symptoms and high pressure in the lungs may be needed. This procedure (lung artery banding) narrows the lung artery to decrease the blood circulation to the lungs. When the child is older, an operation is done to eliminate the band and repair the VSD with open-heart surgery.

What activities can my child do?

If the VSD is small, or if the VSD has actually been closed with surgery, your child might not require any unique safety measures concerning exercise and can take part in normal activities without increased risk.

What will my child need in the future?

Depending upon the place of the VSD, your child’s pediatric cardiologist will analyze your child periodically to try to find uncommon problems, such as a leak in the aortic valve. Hardly ever, older children with small VSDs may need surgery if they develop a leak in this heart valve. After surgery to close a VSD, a pediatric cardiologist will examine your child frequently. The cardiologist will make certain that the heart is working typically. The long-term outlook readies and usually no medicines or extra surgery are required.

Ventricular Septal Defect in Children

What about preventing endocarditis?

Inquire about your child’s risk of endocarditis. Your child’s cardiologist might suggest that your child receive antibiotics prior to certain dental procedures for an amount of time after VSD repair. See the area on Endocarditis for more information.

What is it?

A ventricular septal defect (VSD) is a defect in the septum between the right and left ventricle. The septum is a wall that separates the heart’s left and right sides. Septal problems are in some cases called a “hole” in the heart. It’s the most typical genetic heart flaw in the newborn; it’s less common in older children and grownups because some VSDs close on their own.

What causes it?

In most people, the cause isn’t really understood but genetic aspects may play a role. It’s a typical type of heart defect. Some people can have other heart defects together with VSD.

How does it affect the heart?

Typically, the left side of the heart only pumps blood to the body, and the heart’s right side just pumps blood to the lungs. When a large opening exists between the ventricles, a large amount of oxygen-rich (red) blood from the heart’s left side is forced through the problem into the right side. This blood is pumped back to the lungs, despite the fact that it has already been revitalized with oxygen. Sadly, this causes the heart to pump more blood. The heart, specifically the left atrium and left ventricle, will start to expand from the added work. Hypertension might happen in the lungs’ blood vessels due to the fact that more blood exists. Over time, this increased lung hypertension might permanently harm the blood vessel walls. When the problem is little, not much blood crosses the flaw from the delegated the right and there’s little result on the heart and lungs.

How does the VSD affect me?

In youth a large opening might have caused breathing troubles and for that reason, most of these children had surgery to close the problem. Therefore, large VSDs in adults are unusual, however when they exist, can cause shortness of breath.

Many adults have small VSDs that don’t usually cause symptoms because the heart and lungs do not need to work more difficult. On health examination, small VSDs produce a loud murmur. Even small VSDs may occasionally be a source of infection called endocarditis.

What if my VSD is very small or closed by itself?

Lots of children who had a VSD did not need surgery or other treatments, and many of these flaws closed on their own. Grownups who were informed they “had a hole in their heart” that closed on its own usually have no whispering and a regular EKG. If an echocardiogram is carried out, it might reveal an outpouching called a ventricular septal aneurysm in the area where the VSD was located. If the aneurysm isn’t really acknowledged as an expected finding after a VSD has closed, it can lead to unnecessary issue and screening.

If my VSD was closed in childhood, what can I expect?

If the opening was large, it’s likely that open-heart surgery was performed.

VSD closure is typically performed by stitching a patch of material or pericardium (the typical lining around the beyond the heart) over the VSD to close it totally. The normal heart lining tissue eventually grows to cover this patch and it becomes a long-term part of the heart. Some defects can be sewn closed without a patch. It’s now possible to close some types of VSDs in the catheterization lab using a special device that can “plug” the hole and some more youthful grownups may have had this procedure.
Patients with repaired VSDs and regular pulmonary artery pressures have regular life-spans. Late problems are unusual, but a little number of patients may have problems with the heart valves (aortic or tricuspid) or extra muscle inside the right side of the heart. Anybody who had surgery for a VSD needs a routine check up with a cardiologist who is experienced with grownups with hereditary heart flaws. Medications are hardly ever required. In a patient with a big unrepaired VSD, pulmonary hypertension can occur.

What if the defect is still present? Should it be repaired in adulthood?

Typically closure is suggested for little VSDs just if there’s been an episode of endocarditis which is a heart infection that might be because of the VSD, or if the place of the VSD impacts the function of among the heart valves. If the VSD is large, the pressure in the lungs figures out whether it can be closed in an adult patient. Those with low lung pressures will take advantage of surgery; those with high pressures may or might not.

Issues You Might Have

Patients with little VSDs that remain open have a little risk of a heart infection called endocarditis. The aortic valve may develop leakage and should be monitored.

Patients whose VSD has been repaired early in life are not likely to have any significant long-term issues. If the ventricular septal problem is totally closed without a leak in the patch, the risk of late infection, endocarditis, is minimal. Seldom, irregular heart rhythms can occur. In some people, the heart muscle might be less able to agreement following a VSD repair. If heart failure develops as a result of the heart muscle weak point, diuretics to manage fluid accumulation, representatives to assist the heart pump much better and drugs to manage blood pressure are often given.

In the uncommon patients with a VSD and pulmonary hypertension, medical therapy may be required.

Ongoing Care:

Medical Follow-up

A cardiologist needs to analyze you frequently. If your VSD is little or was closed as a child and no other problems are discovered, gos to every 3– 5 years are probably enough.

What will I need in the future?

Medications might be needed just if you have heart failure (which is extremely uncommon) or if you have pulmonary hypertension. Your cardiologist can monitor you with noninvasive tests if needed. These include electrocardiograms, Holter monitors, exercise stress tests and echocardiograms. They will help reveal if more procedures, such as a heart catheterization, are needed.

Activity Limitations

The majority of patients will not have to limit their activity. However, if you have lung hypertension or your heart does not pump as well as it used to, you may have to restrict your activity to your endurance. Your cardiologist will assist determine if you need to restrict your activity.

Endocarditis Avoidance

Unrepaired VSDs don’t need endocarditis prophylaxis, according to the most current suggestions of the American Heart Association. After the VSD is successfully closed, preventive treatment is required only during a six-month recovery duration. See the section on endocarditis for additional information.

Pregnancy

As soon as the VSD is closed and there’s no leftover pulmonary hypertension, the risk from pregnancy is low. If the VSD remains open, it will be needed to talk to your cardiologist. Unless lung hypertension exists, pregnancy might be well tolerated, but before you decide to obtain pregnant you have to discover the exact threats to you and your child. See the sections on Pregnancy and Genetic Counseling to learn more.

Will You Required More Surgery?

People whose ventricular septal problems are fixed seldom need more surgery unless the spot leaks or other holes are found later. If this happens, whether you’ll need surgery depends upon the size of the residual defects.

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