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Ventricular Septal Defect

Ventricular Septal Defect Causes

No one knows what causes ventricular septal defects, but they probably come from a malformation of the heart that occurs while the infant is developing in the womb.

  • There may be just one hole or several holes in the septum.

  • The septum itself is divided into multiple areas, including the membranous part, the muscular part, and other areas called the inlet and outlet. Any or all of these parts can have a hole.

  • The location of the hole depends on where the malformation takes place during fetal development.

The most common type of ventricular septal defect is the membranous variant. In this type, the hole is located below the aortic valve, which controls flow of blood from the left ventricle into the main artery of the body, the aorta.

Ventricular Septal Defect Symptoms

Small holes in the ventricular septum usually produce no symptoms but are often recognized by the child's health care provider when a loud heart murmur along the left side of the lower breast bone or sternum is heard. Large holes typically produce symptoms 1-6 months after an infant’s birth. The left ventricle begins to fail, producing the following symptoms:

  • Fast breathing

  • Sweating

  • Pallor

  • Very fast heartbeats

  • Decreased feeding

  • Poor weight gain

When a ventricular septal defect is not detected early in life, it can cause more severe problems and more severe symptoms as time goes on. The biggest concern is development of high pressure in the lungs (pulmonary hypertension). If the ventricular septal defect is not surgically closed, irreversible pulmonary hypertension can develop, and the child may no longer benefit from surgery. The following are typical symptoms of pulmonary hypertension:

  • Fainting

  • Shortness of breath

  • Chest pain

  • Bluish discoloration of the skin (cyanosis)

The skin turns faintly bluish when the tissues are not receiving quite enough oxygen. This condition is often termed "hypoxemia" or "hypoxia."

When to Seek Medical Care

Any of the following should be reported to your child's health care provider:

  • Poor weight gain or slowing of weight gain in the first months of life

  • Unusual behavior

  • Any of the other symptoms noted in the previous section

An immediate visit to the nearest hospital emergency department is warranted if you notice any of the following in your infant:

  • Shortness of breath, breathing difficulty of any type, or worsening of an existing breathing problem

  • Bluish color of the skin, lips, or under the nails

  • Unusual or unexplained sweating

Exams and Tests

If a ventricular septal defect is noted before your baby leaves the hospital, several tests may be ordered before discharge.

 

  • An echocardiogram (an ultrasound picture of the heart), a chest X-ray, and blood tests may be taken.

  • You will be asked to follow-up with your child's primary care provider, and you will have to watch closely for signs and symptoms that suggest congestive heart failure or hypoxia.

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