Patient education: Ventricular septal defects in adults (The Basics)

What is a ventricular septal defect? — A ventricular septal defect (or "VSD") is a hole between 2 sections of the heart. The heart is divided into 4 spaces, called "chambers." People with a VSD have a hole between the 2 lower chambers, called the "ventricles" (figure 1). VSDs change the way blood flows through the heart. If a VSD is large or if there are multiple holes, this can cause serious health problems.

A person who has a VSD is usually born with it. In some cases, a VSD develops later in life after a heart attack or medical procedure. This article is about VSDs that are there from birth.

VSDs are often found by a doctor in childhood, but in some cases, a VSD is not found until the person is an adult. It might be found when it starts causing symptoms, or unexpectedly when the person is getting tests for another reason.

What are the symptoms of a VSD? — Many people with a small VSD have no symptoms for years. The VSD is often found when a doctor or nurse hears a heart murmur when listening to a person's heart with a stethoscope. A murmur is an extra sound between heartbeats.

When a VSD does cause symptoms in an adult, they can include:

●Trouble exercising or doing other physical activities – You might also get tired easily just from normal daily activities.

●Trouble breathing

●Swelling of the legs and feet

●Abnormal heartbeat – Your heart might feel like it is racing or skipping beats.

Some people with VSDs also have other heart problems, too. Depending on the problem, symptoms might include fever or skin that looks blue.

Should I see a doctor or nurse? — Yes. If you have trouble breathing, get tired very easily, or have other symptoms, see a doctor or nurse. They will do an exam, listen to your heart, and do tests.

Will I need tests? — Yes. If the doctor or nurse thinks you might have a VSD, they might order the following tests:

●An electrocardiogram (ECG) – This test measures the electrical activity in the heart. It might show a pattern of abnormal electrical activity.

●A chest X-ray – A chest X-ray might be normal, or show changes to the heart or lungs caused by a large VSD.

●An echocardiogram – This test uses sound waves to create a picture of the heart as it beats. This is an important test, because it lets your doctor see where the hole in your heart is, and how big it is. It can also show if there are other heart problems.

How is a VSD treated? — Treatment is different for each person. It depends on how big the VSD is and if it causes symptoms.

Small VSDs usually do not cause any symptoms. They often close on their own during childhood. If you have a small VSD, you will need to see your heart doctor regularly. They will check for any new problems with your heart.

If your VSD is large- or medium-sized, you will most likely need a procedure to close it. This can be done in different ways, depending on where the hole is:

●Surgery to patch the hole – Sometimes other heart problems are fixed during the same surgery.

●A procedure called "transcatheter closure" – In this treatment, a doctor places a thin tube into a blood vessel in an arm or leg. Then, they move the tube through the blood vessel to the heart. When the tube gets to the hole in the heart, the doctor uses the tube to put in a small device that closes the hole.

What if I want to get pregnant? — If you have a VSD and want to get pregnant, talk to your doctor before you start trying.

If you have a small VSD that is not causing symptoms, this will probably not affect your ability to have a normal pregnancy. But your doctor will monitor you and your baby closely to check for any problems.

If you had surgery to close a VSD in the past, and you no longer have related symptoms, this will also probably not affect pregnancy.

In some situations, like if you have pulmonary hypertension, pregnancy could be dangerous for both you and your baby. (Pulmonary hypertension is high blood pressure in the blood vessels that go from the heart to the lungs.) Your doctor can talk to you about your personal risks and options.

More on this topic

Patient education: Heart murmurs (The Basics)
Patient education: Echocardiogram (The Basics)
Patient education: Atrial fibrillation (The Basics)
Patient education: Pulmonary hypertension (The Basics)
Patient education: Aortic regurgitation in adults (The Basics)