Cardiac Center

Ventricular Septal Defect (VSD)

Before you begin reading about ventricular septal defects, please read the explanation of how the normal heart works for a basic understanding of the heart's structure and function.

What is a ventricular septal defect?

Ventricular Septal Defect (VSD)
View Large Ventricular Septal Defect (VSD) Illustration
A ventricular septal defect (VSD) is an opening in the tissue (the septum) between the heart's lower chambers (the ventricles). A VSD is one of the defects referred to as "a hole in the heart."

When the VSD is large, the heart may have to pump harder to deliver enough oxygen to the body. Patients with a small VSD usually do not have any symptoms.

Sometimes children with a VSD also have other heart abnormalities.


What are the symptoms of a ventricular septal defect?

If the hole is large, a child with a ventricular septal defect might exhibit symptoms including:

  • Rapid heartbeat
  • Difficulty feeding
  • Heart murmur - the heart sounds abnormal when a doctor listens with a stethoscope


How is a ventricular septal defect diagnosed?

A VSD might be diagnosed before birth, with fetal echocardiogram. In this case, our Fetal Heart Program will prepare a plan for care after birth.

Or, a VSD might be diagnosed soon after birth, if the newborn exhibits symptoms or a doctor notices a heart murmur. Sometimes a VSD isn't diagnosed until the child is older.

Diagnosis of a ventricular septal defect may require some or all of these tests:

  • Echocardiogram (also called "echo" or ultrasound) - sound waves create an image of the heart
  • Electrocardiogram (ECG) - a record of the electrical activity of the heart
  • Chest X-ray
  • Cardiac catheterization - a thin tube (catheter) is inserted into the heart through a large vein in the leg
  • Cardiac MRI - a three-dimensional image that shows the heart's abnormalities

It is important that a VSD be diagnosed and treated, as needed, or the heart and the arteries between the heart and lungs might be damaged.


What are the treatment options for a ventricular septal defect?

Treatment for a ventricular septal defect will depend on your child's health and on the size of the VSD. Doctors may wait to see if the VSD will close on its own. Many small VSDs will do so before the child is 2 years old.

If the VSD requires surgery, doctors might wait until your child is older and stronger. During that time, your child may have to take medicines as well as have higher-calorie feeds to help with the symptoms. Our surgeons are among the most experienced in the nation in VSD closure. If surgery is needed, they will place a patch or stitches to close the hole during open-heart surgery.


What kind of follow-up care is required for a ventricular septal defect?

Through age 18

After a VSD repair, many children recover quickly and won't experience additional cardiac problems. They must see a pediatric cardiologist for checkups, and some remain on medicine. Rarely, additional surgery is required.

If the child has other heart abnormalities, more follow-up care will be required.

Our pediatric cardiologists follow patients until they are young adults, coordinating care with primary care physicians.

Into adulthood

It's important that adults who were born with a VSD continue to see a cardiologist. We will help patients transition care to an adult cardiologist when the time comes. 

The Philadelphia Adult Congenital Heart Center, a joint program of The Children's Hospital of Philadelphia and Penn Medicine, meets the unique needs of adults who were born with heart defects.

Because of enormous strides in medicine and technology, today most children with heart conditions go on to lead healthy, productive lives.


Contact us

Contact the Cardiac Center at The Children's Hospital of Philadelphia for a second opinion or for more information.

Reviewed by: Paul E. Farrell Jr., MD, MBA, FAAP, FACC
Date: July 2013

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VSD - Patient Stories

Nora's story - Diagnosed with a VSD at 2 days of age and had open-heart surgery at CHOP.

Bridget's story - Now 23, Bridget received the best cardiac care from CHOP-Penn team before, during and after her pregnancy.