What Is Ventricular Septal Defect?

Ventricular Septal Defect or VSD is a congenital heart abnormality in the form of a hole in the separation wall ( septum ) between the right ventricle and the left ventricle of the heart. In most cases, the ventricular septal defect appears at the bottom of the aortic valve. This valve functions to control blood flow from the left ventricle to the main arteries in the body, the aorta.

The ventricular septal defect causes oxygen-rich blood not to be pumped throughout the body, but re-enters the lungs. As a result, the work of the heart becomes heavier. This anatomical abnormality of the heart is generally a congenital disorder acquired from birth. If small, ventricular septal defects can close by themselves after some time. But if it is large, it must be closed through surgery.

Under normal conditions, blood is pumped from the right side of the heart to the lungs to get oxygen, and re-enter the left heart. Then the left heart is responsible for pumping oxygen-rich blood throughout the body. The presence of a ventricular septal defect causes blood from the left ventricle of the oxygen-rich heart to mix with the blood in the right ventricle of the heart which has not been oxygenated. This forces the heart, both the right and the left, to work harder.

Symptoms of Ventricular Septal Defect
Ventricular septal defects are often not immediately detected at birth, especially if the defect hole is small. In fact, this disorder may not show symptoms until entering childhood.

Symptoms of ventricular septal defects vary, depending on the size of the defect hole and the presence or absence of other accompanying heart defects. Here are some symptoms of ventricular septal defects that are often found in infants or children:
  • Shortness of breath and easily tired.
  • Loss of appetite.
  • Obstructed weight gain.
  • Breathing hard and sweating a lot when eating or crying.
  • Pale skin, and may turn blue around the lips and nails.
  • Frequent respiratory infections.
  • Fast and irregular heartbeat.
These symptoms will be very dangerous if ignored and can be fatal.

In adults, the symptoms of a ventricular septal defect are usually breathless both during activity and while lying down, a fast and irregular heartbeat, and often feel tired and weak. The symptoms that appear are generally lighter so often overlooked. But if it is not addressed, complaints can become increasingly severe.

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Causes of Ventricular Septum Defect
Ventricular septal defects are generally congenital heart abnormalities due to a disturbance in the process of heart formation during the fetus, where the separation wall between the right chamber and the left ventricle of the heart does not close completely. The cause of this disorder itself is still unclear. However, it is well known that ventricular septal defects are more prevalent in Asians, in people with a history of congenital heart disease, and in people with genetic disorders, such as Down syndrome.

Although very rare, ventricular septal defects can also occur in adulthood, usually after a heart attack or due to chest injury.

Diagnosis of Ventricular Septum Defect
On the physical examination of the patient's ventricular septal defect, the doctor will find a heart murmur (heart sound that sounds like a sigh). A follow-up examination will then be carried out to confirm the diagnosis is:
  • Pulse Oximeter . A portable device for measuring oxygen levels in the blood by placing the sensor at the patient's fingertips.
  • Echocardiogram . This test is done to get a picture of the heart and its parts using sound waves. The resulting image is in the form of a moving graph displayed on the tool screen.
  • Heart rate . This method is done by inserting a thin elastic hose (catheter) through a blood vessel in the groin, neck or arm, to be directed towards the heart.
In addition, the following checks can also be done to see if complications have occurred:
  • Chest X-ray . The method of imaging with electromagnetic waves to see the condition of the heart and lungs.
  • Electocardiogram . This test is done by attaching leads to the skin, to record the heart's electrical activity.

Treatment of Ventricular Septum Defects
Surgery is the main treatment option, especially if the defect hole is large and causes significant symptoms. Medications can be given to treat symptoms before surgery can be done, or until the patient's condition allows for surgery. In ventricular septal defects that are small, often the hole can close by itself. In such cases, drugs can also be given to treat symptoms that may arise, while monitoring the patient's progress.

Some operating procedures that are commonly performed are:
  • Closure with a catheter . The closure of the hole in the septum is done by a cardiac catheterization process, without surgery.
  • Heart surgery . Performed by opening the chest cavity and suturing holes in the heart septum. During surgery, the work of the heart and lungs is temporarily replaced by a machine called the heart-lung machine .
  • Hybrid procedure . In the combined procedure, the incision is made only small to insert a catheter into the heart, without opening the chest cavity and without the need to temporarily stop the work of the heart. The closure of the hole in the septum is then done through a catheter. With more minimal injuries, the recovery period with this procedure is certainly faster than the surgical procedure.
Medications that can be given to treat symptoms that appear in ventricular septal defects include:
  • Diuretic. This type of drug is used to reduce excess fluid from the body so that the heart works lighter and the patient feels better.
  • Vasodilator . Can reduce the pressure on the patient's left ventricle and make the heart beat more regular.
  • Digoxin . Increases the strength of the heart muscle to pump blood.

Complications of Ventricular Septal Defects
Small ventricular septal defects may not cause problems. However, if the defect hole is medium to large, this disorder can cause serious problems that may lead to death, therefore it must be dealt with immediately.

The longer the ventricular septal defect is left without treatment, the worse the problems and symptoms it causes. The initial treatment done aims to prevent complications such as pulmonary hypertension, hypoxemia, hypoxia, endocarditis, and other heart disorders.

Prevention of Ventricular Septum Defects
In general, nothing can be done to prevent the occurrence of ventricular septal defects. But at least the application of a good lifestyle to maintain the health of the womb and the fetus during pregnancy should still be done. Among others are:
  • Eat healthy food.
  • Exercise regularly.
  • Have a balanced diet.
  • Keep away from cigarettes, narcotics and alcohol.
  • Avoid infection.
  • Control diabetes.

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