Dr. M.J. Bazos, MD. Patient Handout


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.

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.