Dr. M.J. Bazos, MD.
Patient Handout
VENTRICULAR SEPTAL
DEFECT
About Your
Diagnosis
The ventricles are the lower
chambers of the heart. The septum is the heart muscle wall that divides the left
and right sides. A defect in the septum produces a hole in the heart. These
defects develop before birth (congenital) and may persist as a hole into
adulthood. The defect usually closes or is surgically closed in childhood. If
the defect is near the aortic valve, damage to the valve may occur as one grows.
The left side of the heart normally pumps under higher pressure than the right
side. The ventricular septal defect produces a left-to-right shunt that allows
blood from the two sides of the heart to mix. This causes blood with less oxygen
to be pumped to the body and oxygenated to travel back to the lungs. This can
overload the circulation on the right side of the system (pulmonary
hypertension). If the defect is small, it may not cause a problem. Large defects
eventually overload the right heart system. This results in heart failure
(inefficient pumping of the heart) and causes fatigue, difficulty breathing,
especially with exertion, or chest pain. Cyanosis, a bluish tone to the skin,
sometimes occurs when the poorly oxygenated blood reaches the skin. Abnormal
heart rhythms (arrhythmias) may
develop.
Living With Your
Diagnosis
Ventricular septal defects
are the most common type of congenital heart abnormality and are more common
among girls than boys. The defect may close as you grow, but it may persist into
adulthood. If you have a small defect or the defect closes, you may never have
symptoms and usually need no treatment. If the defect persists, you may have
symptoms that necessitate treatment to correct the defect. Ventricular septal
defect is diagnosed on the basis of symptoms and findings at a physical
examination. An electrocardiogram (ECG) may show some abnormalities. A chest
radiograph (x-ray) may be abnormal, showing enlargement of the lung
vessels
and an enlarged heart. An
echocardiogram (ultrasound examination of the heart) is used to assess the
structure and pumping function of the heart and to measure ventricular function
and relative pulmonary (lungs) to systemic (body) blood
flow.
Treatment
Persons
with ventricular septal defects are usually referred to a cardiologist.
Treatment of patients with excessive pulmonary flow involves an operation to
correct the defect. Heart failure if it develops may be managed with diuretics
to reduce excess blood volume or with digitalis medicines to help the
contracting efficiency of the heart. Vasodilator medications may be used to
reduce the pressure against which the ventricle pumps. Arrhythmias may be
managed with antiarrhythmic drugs. Sometimes replacement of the aortic valve is
needed. If there is no other heart disease, correcting the defect usually allows
a normal life span and lifestyle.
If you
have an open ventricular septal defect or have undergone surgical closure of the
defect, antibiotics are required before and after dental or surgical procedures.
This helps prevent bacterial endocarditis, an infection of the lining of the
heart muscle.
The
DOs
•Take your regularly
prescribed medications.
•Take
antibiotics as prescribed before and after dental and surgical
procedures.
The
DON’Ts
•Do not neglect
worsening symptoms. Seek medical attention for
evaluation.
When to Call Your
Doctor
•If you have symptoms of
ventricular septal defect.