Ventricular septal defect (VSD)

PDF download is not available for Arabic and Urdu languages at this time. Please use the browser print function instead

Learn about ventricular septal defects (VSD), an opening in the wall between the ventricles of the heart.

Key points

A VSD is usually detected when a health-care provider hears a heart murmur.
Treatment for VSDs depends on the size of the hole and can range from no treatment to open heart surgery.
The outlook for children with this condition is very good.

Introduction

An opening in the wall between the two lower chambers of the heart is known as a ventricular septal defect. A VSD causes blood high in oxygen to leak from the left side of the heart, where the pressure is higher, to the right side. With large VSDs, this is a problem because too much blood flows to the lungs. This forces the heart to overwork and makes it bigger.

More information

Types of VSDs

There are four types of VSDs, named according to where they occur in the septum:

membranous defect
muscular defect
inlet defect
outlet defect

The two images below compare a normal heart to a heart with a ventricular septal defect.

Normal heart showing placement of the atria, ventricles, aorta, superior vena cava, inferior vena cava, pulmonary artery and pulmonary veins — The heart has two upper (receiving) and two lower (pumping) chambers. Blood flows into the upper chambers (the right atrium and the left atrium). The lower chambers (the right and left ventricles) pump blood out of the heart. The heart valves open and close to keep blood flowing in the correct direction.

Heart showing pulmonary artery with extra blood flow to lungs, enlarged left ventricle, right ventricle, and a hole between ventricles allowing blood to flow from left to right ventricle. — A ventricular septal defect (VSD) is a hole in the wall dividing the two lower chambers of the heart, the right and left ventricle. This hole allows blood to pass from the left ventricle into the pulmonary artery and then to the lungs. The amount of extra blood flow to the lungs depends on the size of the VSD.

Signs and Symptoms

What are the signs and symptoms of ventricular septal defect?

A VSD does not usually cause symptoms if it is small and does not allow much blood to pass through. Most babies with a VSD have a heart murmur.

For about 5% to 10% of cases, a VSD may cause congestive heart failure. Babies with large VSDs usually develop symptoms in the first few weeks or months of life. They may develop fast breathing, fast heart rates and get tired or sweat with feeding. Because their hearts are working harder, they also need more calories and nutrition to gain weight and grow.

Causes, Risk Factors, Prevalence

How many children have ventricular septal defect?

VSD accounts for about 20% of congenital heart disease. About five to 50 children out of 1,000 are born with a VSD.

Diagnosis

Diagnosis of VSD

These defects are usually identified when a health-care provider hears a heart murmur. A chest X-ray, electrocardiogram and echocardiogram or, in rare cases, cardiac catheterization, may be done to diagnose this condition.

Treatment

How is ventricular septal defect treated?

VSDs occur in a range of sizes and their treatment is very individual. Small holes may need no treatment. They often do not cause symptoms and may close on their own. Babies with symptoms caused by a VSD may need medication and increased calories to control symptoms and improve weight gain.

Children with large VSDs who have congestive heart failure are most likely to require surgery to repair and close the VSD. This is done during open heart surgery by applying a patch over the hole. Sometimes, a closure device can be inserted through cardiac catheterization.

If there are several holes, the cardiologist may insert a band around the pulmonary artery, in a procedure called pulmonary artery banding. This allows the baby to grow until the child is better prepared for surgery to close the holes.

Follow-up care

What is the long-term outlook for children with ventricular septal defect?

Whether surgery is required or a VSD spontaneously closes or does not cause symptoms, the outlook for children with this defect is very good.

Last updated: March 18th 2025