A Ventricular Septal Defect (VSD) is a congenital heart defect characterized by a "hole" between the lower two chambers of the heart. VSD is the most common of all the congenital defects and according to the Cincinnati Children's Hospital in the USA Ventricular Septal Defects account for about 30% of heart defects or 0.4% of all live births.
The heart consists of four chambers. The top two chambers are called atria. The lower two chambers are called ventricles or the "pumping" chambers.
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Normally, oxygen-poor blood returns to the right atrium from the body, moves into the right ventricle, and is pumped to the blood vessels in the lungs where it receives oxygen. Oxygen-rich blood returns to the left atrium from the lungs, moves into the left ventricle and is pumped to the body through the aorta.
A heart with a VSD allows oxygen-rich blood to pass from the left ventricle to the right ventricle during contraction. The body's blood pressure is much higher than the blood pressure in the lungs and blood flows in the path of least resistance.
When a child with a VSD is not diagnosed and treated within the first few months of life, this heart defect can cause lung disease and congested heart failure. A small opening between the ventricles allows for a small amount of blood to pass from the left to the right side (left-to-right shunt). Usually, a small VSD closes on its own, however a larger opening allows for more blood to shunt from left to right.
For a while the lungs are able to compensate for the extra blood volume however eventually the blood pressure in the lungs increases thus causing another serious disease, pulmonary hypertension.
The right ventricle now needs to work harder to pump the large volume of blood through the lungs with increasing blood pressure. Eventually, the right ventricle forms a thick muscle wall with less ability to pump the blood, also called cardiac hypertrophy. When the heart no longer functions as an efficient pumping mechanism, it is in heart failure.
Surgical treatment is usually indicated to repair the VSD to prevent further damage to the lungs and heart. In addition, children with VSD are much more prone to bacterial endocarditis which is infection of the heart tissue. Such bacterial infection in the bloodstream can easily infect the already injured heart.
In developed countries a child with a VSD is usually diagnosed within the first few weeks to months of life at a well-baby check up. The child can be treated immediately with medications and/or surgical treatment to prevent further damage to the lungs and heart.
Children who are admitted with VSD at the Shanghai Chest Hospital where the Heart to Heart Shanghai conducts play activity sessions are usually admitted with some progression of pulmonary hypertension and/or congested heart failure.
Many of the families are from rural communities and these parents seek the help of a physician only after the child is showing severe symptoms of VSD. The child may have been experiencing poor weight gain due to tiring while feeding, inability to perform daily activities such as walking to school or help with house chores, or has acquired a severe respiratory infection.
A child receiving corrective heart surgery for a VSD usually recovers well and is able to resume normal activities within a few months of surgery. Surgical intervention undoubtedly extends the life span of the child and provides the child with the same quality of life opportunities as a child with a normal heart within their community.
Heart to Heart Shanghai volunteers, along with the parents and medical staff of the Shanghai Chest Hospital enjoy seeing children with VSDs recover after their surgeries. Post surgery the children are happy, active, and show a good appetite and they will hopefully all lead long healthy and happy lives.
Article compiled by Heart to Heart Shanghai volunteer May Casazza, RN
Reference source: http://www.cincinnatichildrens.org/health/heart-encyclopedia/anomalies/vsd.htm
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