A Ventricular Septal Defect (VSD) is a common congenital heart defect characterized by one or more holes in the septum that separates the heart's two lower chambers, the ventricles. This defect allows oxygen-rich blood from the left ventricle to mix with oxygen-poor blood in the right ventricle.

Types of VSD

VSDs are classified based on their location in the ventricular septum:

  1. Membranous VSD: The most common type, occurring in the upper part of the septum.

  2. Muscular VSD: Located in the muscular part of the septum.

  3. Inlet VSD: Near where blood enters the ventricles.

  4. Outlet (or Supracristal) VSD: Near the valves that lead out of the ventricles.

Symptoms

Symptoms of a VSD can vary greatly depending on the size of the defect and the amount of blood that passes through it:

  • Small VSDs often cause no symptoms and may close on their own.

  • Moderate to large VSDs can lead to signs of heart failure, such as rapid breathing, breathlessness, and poor feeding and growth in infants.

  • In older children and adults, symptoms might include shortness of breath, fatigue, and heart palpitations.

Diagnosis

VSD is typically diagnosed using:

  • Echocardiogram: An ultrasound that visualizes the heart's structure and function.

  • Chest X-ray: To view the size and shape of the heart and lungs.

  • Electrocardiogram (ECG): To measure the heart’s electrical activity.

  • Cardiac MRI: In some cases, for detailed images of the heart.

Treatment

The treatment for a VSD depends on its size, location, and the symptoms it causes:

  • Small VSDs that cause no symptoms may only require observation, as they often close on their own.

  • Medium or large VSDs that cause symptoms usually require surgical repair. This can be done with open-heart surgery or, in some cases, a less invasive catheter procedure.

  • Medication may be used to manage symptoms in some cases, especially in infants, to allow time for the VSD to close on its own or to improve the condition of the heart for surgery.

Long-term Outlook

The prognosis for individuals with a VSD is generally very good, especially for those with small defects that close on their own or after successful surgical repair. However, regular follow-up with a cardiologist is important to monitor heart function and detect any potential complications, such as heart rhythm abnormalities, aortic valve problems in cases of supracristal VSD, or, rarely, pulmonary hypertension if the VSD is large and untreated.