What is VSD (Ventricular Septal Defect) Size, Causes and Treatment

One of Bollywood’s most vivacious and enigmatic beauties, Madhubala died at the young age of 36 years. What exactly was the ailment that claimed her life? It was a congenital heart defect called ventricular septal defect (VSD). Born as a ‘blue baby,’ as such babies are referred to; she had a hole in her heart wall that separates the right and the left ventricles.

This condition causes a ‘leakage’ of blood from one ventricle to another and the resultant complication can be life-threatening if not treated on time. However, this condition is successfully treated today in most children. Ventricular septal defect (VSD), common known as ‘hole in heart’, occurs in 0.1 to 0.4 percent of all live births and makes up about 20 to 30 per cent of congenital heart lesions. This is hence, one of the most common congenital diseases of the heart.

Many infants who have a very small hole do not show heart-related symptoms. However, infants with medium or large VSD can develop heart failure. If a child complains of exhaustion of loss of breath, if he/she tries to run or play, then it could be a symptom of the defect.

What is VSD

What is VSD?

The right and left ventricles of the heart are not separate before the baby is born. Inside the mother’s womb as the foetus grows, a wall forms to separate these two ventricles. In cases where the wall does not completely form due to a defect, a hole remains. This hole is known as a ventricular septal defect. So mostly, it is a birth defect (congenital).

Causes of VSD:
As with many other congenital diseases, the exact cause of the defect is not yet completely understood. However, it is believed that the congenital heart defect results from certain problems that happened early in the heart’s development. Factors such as genetics and environment are considered to play a role in the occurrence of VSD. Notably, in some cases, VSD occurs by itself, while in others it occurs with other congenital diseases.

“Many infants who have a very small hole in the heart don not show heart-related symptoms. However, infants with medium or large VSD can develop heart failure.”

Size and Location:
The location and size of the hole or VSD within the septum determines in part the consequences of the ventricular septal defect. A small-sized VSD rarely causes a problem. Additionally, such VSDs also do not show any kind of symptoms and are recognized by a murmur, an extra heart sound heard via a stethoscope during a regular physical check-up. Due to its small size, the hole does not put any pressure on heart or lungs and therefore skips exhibiting any noticing symptoms.

However, the scenario is very different in the case of a large VSD. During ventricular contraction some of the blood from the left ventricle leaks in to the right ventricle. This blood in turn goes to the lungs and re-enters the left ventricle via the pulmonary veins and left atrium. This complex flow of blood to and fro from the ‘hole’ causes volume overload on the left ventricle while also leading to pulmonary hypertension. Therefore if the hole is large, too much blood will be pumped to the lungs and may cause heart failure.

In such cases, blood leaks from one ventricle to another and eventually to the lungs, extra blood is pumped into the lung arteries making the heart and lungs work harder. The consequent congestion in lungs may also cause permanent damage of the organs. Due to this, the child tends to breathe faster and harder than normal, while infants may face a problem while feeding and growing at a normal rate.

Treatment of VSD:
While the small sized VSD can be treated with minor surgeries and treatment, a large sized VSD often needs open-heart surgery to close the hole. Closing a large VSD by open-heart surgery usually is done in infancy or childhood even in patients with few symptoms, to prevent complications later. However, over the decades, the diagnosis and treatment of VSDs had improved. The developments have enabled the successful closure of the hole to let the child grown to become a normal and productive adult.

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