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Ventricular Septal Defect

more about Ventricular Septal Defect


  • The heart has two ventricles -- a left and a right.  The right ventricle pumps blood returning from the body to the lungs.  The left ventricle takes the blood returning from the lungs and pumps it out to the rest of the body.  There is normally a septum, or wall, separating the left ventricle from the right.
  • Sometimes, a hole may develop at or after birth in this wall.  The symptoms and treatment of this disease depend on the size of the hole.  Often, this problem is detected early and treated in childhood.

  • If the hole is small, the patient may never have any symptoms or may only develop symptoms as an adult.
  • If the hole is large, then it can potentially cause heart failure, poor oxygenation of the blood, bluish discoloration of the fingers and toes, high pressure in the lungs, shortness of breath, swelling of the legs, liver congestion, fatigue, poor weight gain in children, and difficulty breathing when lying flat at night.
  • On examination, the doctor may detect a Heart Murmur or may see evidence of heart failure.

  • Ventricular septal defects are most often due to the failure of the wall separating the left and right ventricle to close fully during a baby's development in the uterus.
  • Rarely, infections of the heart or Injury to the heart (e.g., heart attack) can be the cause of this problem.

  • An electrocardiogram (EKG) may show enlarged heart chambers.
  • Chest X-rays may show an enlarged heart and evidence of heart failure.
  • An echocardiogram (an ultrasound of the heart) is an accurate test to expose the heart defect.
  • A color flow Doppler study can show (in color) the jet flow across the defect.
  • Sometimes an MRI (magnetic resonance Image) of the heart may also show the hole.
  • The best test is a cardiac catheterization (in which dye is injected into the heart and the hole is seen with X-rays).  However, this is not necessary if the other tests can see the hole adequately.

  • If the ventricular septal defect is small and the patient does not have any symptoms, then no treatment is needed.  The patient's life expectancy should be normal.
  • If the defect is large, then without treatment, the patient often develops heart failure early in life and often dies by age 40.
  • Many times these defects heal by themselves and no surgery is needed.
  • However, if the hole has not sealed up by the time the patient is 9 to 12 years old, then surgery to close it will be needed -- to prevent later complications.
  • In some cases, a child with this condition may develop severe symptoms very early, requiring surgery to be done much sooner.  If surgery is delayed too long, the damage may be permanent.
  • In some cases, surgery is possible without opening up the chest.
  • Whether and when surgery should be done needs to be discussed with the doctor.  Also, he will explain the details of the surgery, including dangers and prognosis.
  • In cases where congestive heart failure or other symptoms develop, heart medications (e.g., Nitoglycerin, ACE inhibitors, Hydralazine, diuretics, Digoxin, and others) may be used to control symptoms or until surgery is performed.

 


  • Special Information:
    1. Patients with a ventricular septal defect are at a much higher risk for developing endocarditis (infections of the heart).  This condition can be life threatening, but it can also be prevented.  Therefore, it is absolutely crucial that antibiotics be taken prior to any surgery, including tooth extractions.
    2. If your child has a ventricular septal defect, you must tell his/her doctor and dentist so that they can give the appropriate antibiotics before surgery.



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