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Ventricular septal defect in a newborn baby - what parents need to know

26.11.2024

A ventricular septal defect (VSD) is a hole in the wall between the ventricles of the heart. VSD is a fairly common heart defect, occurring in 5% of every 1,000 newborn babies, accounting for 20% of all congenital anomalies. It is a common heart problem that is present at birth (congenital heart disease).

To understand more about ventricular septal defect, it may help to know how the heart normally works.

The heart has two upper and two lower chambers. The upper chambers, the right and left atria, receive incoming blood. The lower chambers, the more muscular right and left ventricles, pump blood out of the heart. The heart valves, which keep the blood flowing in the right direction, act as what are called the chamber gates.

• The right side of the heart transports blood to the lungs.
• In the lungs, the blood becomes saturated with oxygen.
• The lungs transport oxygen-rich blood to the left side of the heart.
• The left side of the heart transports oxygen-rich blood to the rest of the body.

When the defect is detected, the hole-like defect is located between the lower chambers of the heart (the right and left ventricles). The defect between the ventricles causes oxygen-rich blood to back up into the lungs instead of being distributed to the rest of the body. As a result, oxygen-rich blood is mixed with oxygen-poor blood. These changes can increase blood pressure in the lungs and require the heart to work harder to pump blood.

Ventricular septal defects can be small, medium and large.

A small ventricular septal defect may not cause any problems. The defect of the muscular part of the interventricular septum closes on its own, such patients are subject to dispensary observation. If the hole is large, accompanied by pronounced symptoms, then drug treatment and cardiac surgery are required to eliminate this defect in order to avoid further complications. After surgery, the signs of heart failure disappear.

Symptoms of serious heart problems often appear within the first few days, weeks, or months of a baby's life.

Symptoms and when to see a doctor

Symptoms of a VSD depend on the size of the hole and whether there are any other heart problems.

In general, symptoms in a child may include:

• Poor weight gain (weak sucking with frequent interruptions)
• Lack of appetite
• Rapid breathing or shortness of breath
• Rapid fatigue or increased anxiety

What can a doctor hear?

• A whistling sound when listening to the heart with a stethoscope (heart murmur)

Causes of VSD

Often there is no clear cause. Genetics and environmental factors may play a role. VSDs may occur on their own or in combination with other heart problems present at birth.

Risk factors

• Premature birth
• Down syndrome and other genetic diseases
• Family history of heart problems present at birth (congenital heart defects)

A baby born with a VSD may have other heart problems, such as:

• Atrial septal defect
• Coarctation of the aorta
• Tetralogy of Fallot
• Transposition of the great arteries and others

Complications

A small ventricular septal defect may not cause any problems. In 40% of cases, a small ventricular septal defect will close completely or decrease in size within the first year of life, so these situations usually do not require medical or surgical treatment.

However, sometimes after closure of perimembranous VSDs, rhythm and conduction disturbances may be observed, as well as the possibility of the development or worsening of aortic insufficiency or tricuspid insufficiency.

Survey

The diagnosis of VSD is made based on echocardiography (ultrasound of the heart with Doppler examination), ECG, medical history and examination of the child.

Prevention

It is not always possible to prevent the occurrence of a ventricular septal defect due to uncertainty about its exact origin. Careful planning of pregnancy is important.

Get early prenatal care before you get pregnant. Talk to your doctor about your health before you get pregnant and discuss any lifestyle changes you may need to make. Also, be sure to talk to your doctor about any medications you are taking:

• Follow your obstetrician/gynecologist's recommendations.
• Avoid alcohol. Drinking alcohol during pregnancy increases the risk of congenital heart defects.
• Don't smoke or use drugs. Smoking during pregnancy increases the risk of congenital heart defects in the baby.
• Get recommended vaccinations. Some infections can pose risks to a developing fetus. For example, rubella virus during pregnancy can cause problems with the baby's developing heart.
• Monitor your blood sugar (especially if you have diabetes). Closely monitoring your blood sugar before and during pregnancy can reduce the risk of congenital heart defects in your baby. Diabetes that develops during pregnancy (gestational diabetes) does not usually increase the risk to your baby. If you have diabetes, talk to your doctor to make sure it is well controlled before you become pregnant.
• If you have a family history of congenital heart defects, consider talking to a genetic counselor and cardiologist before becoming pregnant.

What to ask your doctor if you suspect a congenital heart defect in your newborn baby

1. Does my child have VSD or another condition ?
2. What examination should I undergo ?
3. What treatment is needed ?
4. How big is the hole diameter ?
5. Does my child need surgery ?

Pediatrician N.Yu. Panferova

Neonatologist I.V. Lomskaya, highest qualification category