Ventricular Septal Defect
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.
A ventricular septal defect is detected on physical examination by a systolic murmur audible with a stethoscope along the lower left sternal or breast bone border. It is related to the oxygenated blood “swishing” through the hole or VSD into the right ventricle.
The presence of a hole in the heart can be confirmed by echocardiogram. This painless test uses ultrasound waves to construct a moving picture of the heart. It can quantitate the size of the left-to-right shunt by enlargement of the left ventricle, pressure in the lungs, and actually estimate the degree of shunting by an empirical formula.
Chest X-ray is useful to see if the overall heart size is enlarged, and may demonstrate evidence of fluid in the lungs or pulmonary congestion. An electrocardiogram is helpful to evaluate the sizes of the left and right ventricle. If right ventricular hypertrophy is indicated, this may suggest pulmonary hypertension.
Cardiac catheterization may be performed in certain circumstances.
- In this procedure, a very thin plastic tube called a catheter is inserted into the skin in the groin, arm, or neck (under local anesthesia with minimal pain) and advanced to the heart under X-ray observation by the cardiologist.
- Pressures are measured inside the heart, especially if any concern was previously raised over the degree of pulmonary hypertension and therefore operability. If the lung pressures are very high and won’t drop with oxygen and additional vasodilating drugs, the patient may not be operable.
- If additional abnormalities are possible, a dye study may be performed to visualize the anatomy of inside the heart. But the echocardiogram may accomplish this goal in the majority of patients.