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Ventricular Septal Defect In Children

WHAT YOU SHOULD KNOW:

  • Ventricular septal defect, also called VSD, is the most common congenital heart disease. With VSD, the wall between the ventricles (lower chambers of the heart) failed to form completely. This results in a hole where blood in the left ventricle flows back to the right ventricle. Over time, increased backflow of blood may cause the right ventricle to enlarge. This may lead to other problems, such as abnormal heartbeats and increased blood pressure to the lungs. These problems may make it difficult for the heart and lungs to supply oxygen to the body.

  • Problems during the development of the heart while in the womb are thought to cause a VSD. These problems may include use of certain medicines, alcohol, or illegal drugs or a family history of heart disease. A child with a VSD may not have any signs and symptoms except for a heart murmur. A heart murmur is an abnormal change in heart sounds. VSD is diagnosed by echocardiography, heart catheterization, chest x-ray, electrocardiogram (ECG), or doppler test. Caregivers may want your child to have regular checkups to see if his VSD may close on its own. Treatment may include oxygen, medicines, such as heart medicines or diuretics, surgery, or a transcatheter procedure. With proper treatment, your child has a greater chance of being able to continue with his normal activities. Ask your caregiver for more information about these tests and treatments.

CARE AGREEMENT:

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.

RISKS:

  • Treatment for a ventricular septal defect may cause unwanted side effects. Surgery and catheter procedures may increase the chance of getting a heart infection or bleeding. Antibiotics may be needed to prevent a condition called bacterial endocarditis. Medicines may cause your child to have rashes, nausea, vomiting, or low blood pressure.

  • VSD is a common congenital heart condition. Your child's health, quality of life, and ability to function may change depending on the symptoms present. If left untreated, your child's signs and symptoms may worsen. His heart may weaken and totally fail. This may cause decreased blood flow to the organs and other parts of the body. The blood may also flow back up into the lungs and cause more problems. Your child's lungs may become filled with fluid and cause severe shortness of breath or respiratory failure. Even if your child has treatment, there is still the chance that his heart will fail. Ask your child's caregiver if you have questions or concerns about your child's condition, medicines, or care.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that your child may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your child's medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done to your child. Make sure all of your questions are answered.

Emotional support:

Stay with your child for comfort and support as often as possible while he is in the hospital. Ask another family member or someone close to the family to stay with your child when you cannot be there. Bring items from home that will comfort your child, such as a favorite blanket or toy.

Medicines:

Your child may be given any of the following:

  • Antibiotics: This medicine is given to help prevent or treat an infection caused by bacteria.

  • Diuretics: This medicine may be given to help your child's body and lungs get rid of extra fluid. This can help your child breathe easier. Diuretics may make your child urinate more often.

  • Heart medicine: This medicine may be given to make your child's heart beat stronger or more regularly. There are many different kinds of heart medicines. Talk with caregivers to find out what your child's medicine is and why he is taking it.

Tests and monitoring:

Your child may need any of the following:

  • Blood gases: These tests are also called arterial blood gases (ABGs). Blood is taken from an artery usually in your child's wrist. ABGs may be done if your child has trouble breathing or other problems caused by his illness.

  • Blood tests: Your child may need blood tests to give caregivers information about how his body is working. The blood may be taken from your child's arm, hand, finger, foot, heel, or IV.

  • Cardiac catheterization: A cardiac catheterization is a test to see how well your child's heart is working. It is also used to see how well the blood vessels connected to the heart are doing. A special tube is threaded into your child's heart through a blood vessel in his arm, leg, or neck. Dye may be given so x-ray pictures of your child's blood vessels show up better on a TV-like screen. Your child's caregiver may also measure the pressure inside your child's heart.

  • Imaging tests:

    • Chest x-ray: This is a picture of your child's lungs and heart. A chest x-ray may be used to check your child's heart, lungs, and chest wall. It can help caregivers diagnose your child's symptoms, or suggest or monitor treatment for medical conditions.

    • Doppler test: This test is done to check blood flow in the heart. A small metal disc with gel is placed on your child's chest. Caregivers may hear abnormal sounds when a VSD is present.

    • An echocardiogram is a type of ultrasound. Sound waves are used to show the structure and function of your child's heart.

  • 12 Lead EKG: This test helps caregivers see your child's heart activity. It helps caregivers look for changes or problems in different areas of the heart. Sticky pads are placed on your child's chest, arms, and legs. Each pad has a wire that is hooked to a machine or TV-like screen. This machine shows a tracing of your child's heartbeat. This test takes about five to ten minutes. Your child must lie very still during the test.

  • Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your child's blood. A cord with a clip or sticky strip is placed on your child's foot, toe, hand, finger, or earlobe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your child's oxygen level is low or cannot be read.

Treatment options:

Your child may have any of the following:

  • Respiratory support:

    • Oxygen: Your child may need oxygen if his blood oxygen level is lower than it should be. Oxygen will help your child breathe easier. Your child may get oxygen through small tubes placed in his nostrils, or through a mask. He may instead be placed in an oxygen tent. Never take off your child's oxygen tubes or mask or remove him from the tent without asking his caregiver first.

    • ET tube: Your child may need an endotracheal (ET) tube to help him breathe. An ET tube is put in your child's mouth or nose, and goes into the trachea (windpipe). It may be connected to a breathing machine called a ventilator. The ET tube will be taken out when your child is breathing better.

  • Surgery: Surgery may be done by making an incision (cut) through your child's chest to repair the VSD. Your child's caregiver may plug or patch the hole in his heart. Ask your child's caregiver for more information about surgery for a VSD.

  • Transcatheter device closure: Your child's caregiver may suggest that your child have a transcatheter device closure. This is a procedure where a device called a septal occluder is used to close the hole in the ventricular wall. Ask your child's caregiver for more information on transcatheter device closure for a VSD.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Ventricular Septal Defect In Children (Inpatient Care)

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