Ventricular septal defect

How a ventricular septal defect affects your heart

The lower chambers of your heart (the right and left ventricles) are separated by a wall of muscle, called the ventricular septum.

If you have a VSD you have a hole in this wall. This means when your heart beats blood can flow through the hole.

Blood from the left ventricle (high in oxygen from the lungs) can flow into the right ventricle.

Blood from the right ventricle (low in oxygen) can flow into the left ventricle.

Blood travelling through the hole can make your heart work harder. It can also affect the blood pressure in your lungs and lead to other conditions.

A VSD can cause:

• heart failure
• irregular heart rhythm
• Eisenmenger syndrome
• leaky heart valve
• stroke
• pulmonary hypertension.

Types of ventricular septal defect

There are different types of VSD depending on:

• where the hole is
• how big the hole is
• how many holes there are.

There are two common types of VSD.

• Muscular VSD, in the lower part of the wall between your heart chambers (ventricles).
• Perimembranous VSD, near your heart valves.

You may also hear about less common types of VSD, such as inlet or outlet VSD.

A VSD is sometimes described by its size, for example a small or large VSD.

If you’re not sure what type of VSD you have, speak to your doctor. They can give you more information about your condition and answer any questions you have.

Symptoms of a ventricular septal defect

A VSD usually causes no signs or symptoms.

The blood flowing through the hole can create a swishing noise. This is called a heart murmur. Doctors can hear a heart murmur when they listen to your heart with a stethoscope.

In rare cases, a VSD may cause signs and symptoms in children, such as:

• shortness of breath, especially when exercising
• being very tired
• being underweight and growing slowly
• irregular or extra heart beats, called arrhythmias.

Adults with a VSD may also have signs and symptoms, such as:

• shortness of breath, especially when exercising
• you may not be able to exercise for long
• feeling very tired
• irregular or extra heart beats, called arrhythmias
• fainting.

If you have any of these symptoms, speak to your doctor.

Diagnosing a ventricular septal defect

Most people with a VSD will be diagnosed shortly after they’re born during a routine health check.

If you’re diagnosed as an adult, you may find out when having checks for other conditions or if you’ve been experiencing symptoms.

Tests to diagnose a VSD:

• ECG
• echocardiogram
• chest x-ray
• CT scan
• MRI
• stress test.

Your doctor may also ask you to have a certain type of heart catheterisation to check the working of your heart in more detail. Speak to your doctor if you have questions about this.

These tests do not hurt. Speak to a healthcare professional if you have any questions or worries before having them.

You may be diagnosed with other heart problems when you’re diagnosed with a VSD.

Causes of a ventricular septal defect

The cause of VSD is not known, but it happens when a baby’s heart is developing during pregnancy.

Not knowing what has caused your condition can be frustrating. It can help to find out more about the causes of congenital heart disease.

Treating a ventricular septal defect 

Small VSDs can close by themselves and do not need treatment.

If you have a small VSD that’s not closed by itself, you’ll have regular appointments to check how your heart is working.

Larger VSDs will need to be closed. There are two procedures to close VSDs:

• transcatheter closure
• open heart surgery.

Both procedures are done under general anaesthetic. This is like being asleep and you do not feel any pain. You will be looked after by healthcare professionals throughout the procedure.

A large VSD will usually be closed when you’re a child, but it can also be done as an adult. Most people feel better afterwards and can live a normal life.

Talk to your doctor about what options are available to you. They can answer any questions or worries you have about treatment.

Depending on the surgery you have, you may need to stay in hospital for up to one week. Speak to your doctor or nurse specialist about what to expect during recovery and whether there are support services you can use. For example, if you need help with childcare or extra support when you go home.

Transcatheter closure

This is a type of keyhole surgery. A small cut is made in the skin and a long thin tube (called a catheter) is put into a vein at the top of your leg. It’s guided to your heart to close the hole.

You may be offered a patch or a plug repair. You may hear the patch or plug called a medical device.

Patch repair is a patch made of special material that’s put over the VSD to close the hole and stitched into place. Over time your own tissue will grow over the patch.

Plug repair is a special device that’s inserted through the VSD to fill (or plug) the hole and stays in place for your lifetime.

Open heart surgery

During open heart surgery, the surgeon will work directly on your heart to close the hole.

You’ll be put on a bypass machine, also known as a heart and lung machine. This helps pump blood around your body during the procedure.

The surgeon will cut the bone in your chest (called the breastbone) so they can see your heart. They will then close the VSD by sewing it shut or using a patch or plug.

Recovery after surgery

Once your surgery or procedure is finished, you’ll be taken to a recovery area or intensive care unit. When you’re well enough you’ll be moved to a ward where you’ll recover.

The length of time you stay in hospital will depend on whether you had a surgical or keyhole repair of your VSD.

You may be given blood thinning medicine to take after your procedure to reduce the risk of blood clots forming. The surgical team will talk to you about this before you go home.

It’s normal to have questions about your recovery after surgery. Speak to your surgeon or nurse specialist about recovery, and any other questions you have. You can also read our information on recovery tips after surgery.

Living with a ventricular septal defect

It’s normal to feel anxious after being diagnosed. You may feel worried about your condition and how it will affect your life.

Most people with a small VSD or repaired VSD live a normal, healthy life. It's important to go to your follow-up appointments. Your doctor will let you know how often they need to see you to make sure your heart is healthy.

Read about the emotional impact of living with congenital heart disease.

Questions to ask your doctor

You can talk to your healthcare team about anything. It’s okay to ask questions, even things that feel difficult or uncomfortable to talk about.

You may want to ask about:

• exercising
• diet
• alcohol
• driving
• school or work
• holidays and flying
• sex and contraception
• having children
• support available to you.

It can help to write down questions when you think of them and ask at your next appointment. Having more information can help you to live well with your condition.

Staying active

Most people can exercise normally, and staying active can help you manage your health.

It’s still best to speak to your doctor if you have a VSD to find out what kind of exercise is best for you.

Family planning

If you’re pregnant or planning to have a family, it's important to speak to your doctor. They can discuss options with you, make sure you’re supported and get the right care.

Endocarditis

Endocarditis is a rare infection that causes inflammation of the valves and inner lining of the heart.

People with congenital heart diseases, including VSD, have an increased risk of endocarditis. To reduce the risk of developing endocarditis, your doctor or dentist might recommend antibiotics before or after any surgery or procedures.

More information and support

Your healthcare team are here to support you. You can ask them anything. It might feel uncomfortable or embarrassing to ask questions, but most people feel much better once they do.

Here are some ways you can get support.

• Read common questions about congenital heart disease. We talk about things like alcohol, mental health, preparing for surgery, and more.
• If you still have more questions, speak to our cardiac nurses on our Heart Helpline by phone, callback, email or online chat (Monday to Friday, 9am to 5pm).
• You can also speak to others with heart conditions by joining a support group or online community.