Can You Live With a Hole in Your Heart
What Is a Ventricular Septal Defect?
A ventricular septal defect (VSD) — sometimes referred to as a hole in the middle — is a type of congenital heart defect. In a VSD, there is an abnormal opening in the wall between the main pumping chambers of the heart (the ventricles).
VSDs are the most common congenital heart defect. Most VSDs are diagnosed and treated successfully with few or no complications.
What Happens in a Ventricular Septal Defect?
The right ventricle and left ventricle of the heart are separated by shared wall, called the ventricular septum. Kids with a VSD have an opening in this wall. As a result:
- When the heart beats, some of the blood in the left ventricle (which has been enriched by oxygen from the lungs) flows through the pigsty in the septum into the right ventricle.
- In the right ventricle, this oxygen-rich blood mixes with the oxygen-poor blood and goes back to the lungs.
The blood flowing through the hole creates an extra noise, which is known as a heart murmur. Doctors can hear the heart murmur when they mind to the heart with a stethoscope.
VSDs tin can be in different places on the septum and can vary in size.
What Causes a Ventricular Septal Defect?
Ventricular septal (ven-TRIK-yu-lar SEP-tul) defects happen as a baby's heart develops earlier nativity. The middle develops from a big tube, dividing into sections that volition eventually become the walls and chambers. If in that location's a problem during this process, a hole can course in the ventricular septum.
In some cases, the trend to develop a VSD may be due to genetic syndromes that crusade extra or missing pieces of chromosomes. Nearly VSDs, though, have no clear cause.
What Are the Signs & Symptoms of a Ventricular Septal Defect?
Whether a VSD causes any symptoms depends on the size of the pigsty and its location. Small VSDs commonly won't cause symptoms, and might close on their ain.
Older kids or teens who have pocket-size VSDs that don't shut usually have no symptoms other than the heart murmur. They might need to see a doctor regularly to brand sure the VSD isn't causing whatsoever problems.
Medium and large VSDs may cause noticeable symptoms. Babies may take faster breathing and get tired when they try to feed. They may first sweating or crying while feeding, and may gain weight slowly.
These signs generally indicate that the VSD will not shut by itself, and the child may need eye surgery. Usually, this is washed in the baby's first 3 months of life to prevent other issues. A cardiologist can prescribe medicine to lessen symptoms before the baby has surgery.
What Problems Tin can Happen?
Infants with a large VSD can develop middle failure, and have feeding problems that lead to poor weight gain. They as well may become chest infections often. Children with a minor VSD are at risk for developing endocarditis, an infection of the inner surface of the eye caused by leaner in the bloodstream. Bacteria are always in our mouths, and pocket-sized amounts get into the bloodstream when we chew and brush our teeth.
Skillful dental hygiene to reduce oral bacteria is the best way to protect the middle from endocarditis. Kids should brush and floss daily, and meet their dentist regularly. In general, patients with simple VSDs don't need to take antibiotics before dental visits, except for the outset 6 months afterwards VSD surgery.
How Are Ventricular Septal Defects Diagnosed?
Doctors usually observe a VSD in a baby's showtime few weeks of life during a routine checkup. They'll hear the center murmur, which has certain features that let them know information technology's not caused by something else.
If your child has a centre murmur, the doctor may refer y'all to a pediatric cardiologist (a doctor who diagnoses and treats childhood eye weather condition).
The cardiologist volition exercise an exam and take your child'south medical history. If the doctor thinks there'southward a VSD, they may order tests such as:
- a chest X-ray: a picture of the heart and surrounding organs
- an electrocardiogram (EKG): a tape of the heart'due south electrical activity
- an echocardiogram: an ultrasound of the heart. Often, this is the chief way doctors diagnose a VSD.
- a cardiac catheterization: this provides information nearly the middle'due south structures and the blood pressure and blood oxygen levels in its chambers. This test usually is done for a VSD only when more information is needed than the other tests tin can give. (It's sometimes also used to close sure kinds of VSDs.)
How Are Ventricular Septal Defects Treated?
Treatment depends on a kid'south historic period and the size, location, and severity of the VSD. A kid with a small defect that causes no symptoms may merely need to visit a cardiologist regularly to make certain there are no other problems.
In many kids, a minor defect will close on its own without surgery. Some might not close, just they won't become any larger. Kids with pocket-sized VSDs usually don't need to restrict their activities.
Kids with medium to large VSDs might need prescription medicines to aid circulation and assist the heart work better. Medicines alone, though, won't shut the VSD. So, the cardiologist may recommend heart surgery to prepare the hole. In rare cases, the VSD could be closed by cardiac catheterization instead.
Eye Surgery
Surgery usually is done within the outset few weeks to months of a child's life. The surgeon makes an incision in the chest wall and a heart-lung machine will maintain circulation while the surgeon closes the pigsty. The surgeon tin can sew together the pigsty closed straight or, more commonly, will sew a patch of manmade surgical material over it. Eventually, the tissue of the heart heals over the patch or stitches. By 6 months after the surgery, tissue will completely embrace the hole.
Cardiac Catheterization
Rarely, cardiologists may close some types of VSDs with cardiac catheterization. They insert a thin, flexible tube (a catheter) into a blood vessel in the child'due south leg that leads to the center. They guide the tube into the heart to brand measurements of blood flow, pressure level, and oxygen levels in the centre chambers. A special implant, shaped into two disks formed of flexible wire mesh, is positioned into the hole in the septum. The device is designed to flatten against the septum on both sides to close and permanently seal the VSD.
What Else Should I Know?
In most cases, kids who accept VSD surgery recover quickly and with no complications. But doctors will closely spotter them for signs or symptoms of any problems. Your child will need follow-upward visits with a cardiologist for a while.
If your kid has trouble breathing, telephone call your dr. or go to the emergency room correct away. Other signs of a problem include:
- poor appetite or trouble feeding
- failure to proceeds weight or weight loss
- listlessness or decreased activity level
- a long-lasting or unexplained fever
- increasing pain, tenderness, or pus oozing from the surgery site
Call your doctor if you notice any of these signs in your child after surgery to shut the VSD.
Having your kid diagnosed with a eye condition can be scary. But the good news is that your pediatric cardiologist is very familiar with VSDs and how best to manage them. After surgery, nigh kids go on to live healthy, agile lives.
Source: https://kidshealth.org/en/parents/vsd.html
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