Atrial Septal Defect (ASD)

Ventricular Septal Defect (VSD)

What is a ventricular septal defect?

A ventricular septal defect (VSD) is a heart defect. It’s congenital. This means that your baby is born with it. A VSD is an opening or hole in the dividing wall (septum) between the two lower chambers of the heart (right and left ventricles). VSDs are the most common type of congenital heart defect.

A VSD allows oxygen-rich (red) blood to pass from the left ventricle through the opening in the septum. Then it mixes with oxygen-poor (blue) blood in the right ventricle.

There are different types of VSD. The type your child has depends on which part of the wall between the ventricles is involved. The size of the opening or hole also varies.

What causes a VSD?

VSD may occur more often in some families. This is because of gene defects. Most of the time, the cause of VSD isn’t known.

What are the symptoms of a VSD?

The size of the opening or hole affects how severe your child’s symptoms are. So does the age at which your child first has symptoms. The larger the opening, the more blood passes through it. The right ventricle and lungs have to work harder. 

Your child may have symptoms from birth. Or your child may not have symptoms until he or she is a little older. Symptoms can occur a bit differently in each child. They can include:

  • Tiredness
  • Fast breathing
  • Trouble breathing
  • Poor feeding or tiring while feeding
  • Poor weight gain

The symptoms of VSD may be similar to symptoms of other conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

How is a VSD diagnosed?

Your child's healthcare provider may suspect this issue when he or she hears an abnormal sound (heart murmur) when listening to your child's heart with a stethoscope. If this happens, the healthcare provider may refer your child to a heart doctor for children (pediatric cardiologist).

The heart doctor will check your baby. He or she will listen to your child’s heart and lungs. The details about the murmur will also help the heart doctor make the diagnosis. 

Your child’s doctor may do tests to confirm the diagnosis. The tests your child has depends on his or her age and condition, and the doctor’s preferences.

Chest X-ray

A chest X-ray shows the heart and lungs. With a VSD, a chest X-ray may show an enlarged heart. This is because the left ventricle gets more blood than normal. There may also be changes in the lungs because of extra blood flow.

Electrocardiogram (ECG)

This test records the electrical activity of the heart. It also shows abnormal rhythms (arrhythmias or dysrhythmias) and spots heart muscle stress.

Echocardiogram (echo)

An echo uses sound waves to make a moving picture of the heart and heart valves. This test can show the pattern and amount of blood flow through the septal opening. An echo is often used to diagnose VSD.

Cardiac catheterization (cardiac or heart cath)

A cardiac catheterization gives detailed information about the structures inside the heart. In this test, a small, thin, flexible tube (catheter) is put into a blood vessel in your child’s groin. Then the healthcare provider guides it to your child’s heart. Your child’s healthcare provider will inject your child with contrast dye to see his or her heart more clearly. This test measures your child’s blood pressure and oxygen in the 4 chambers of the heart and the pulmonary artery and aorta. Your child will get medicine to help relax and prevent pain (sedation). This test often isn’t needed if your child is diagnosed with an echo.

How is a VSD treated?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

Small VSDs may close on their own as your child grows. Some small defects don’t close on their own, but they still don’t need treatment. A larger VSD often needs to be fixed with surgery or through cardiac catheterization. Once children are diagnosed with a VSD, their heart doctor will check them regularly to see if it’s closing on its own.

Medicine

Some children may need to take medicine to help the heart work better. Children without symptoms may not need medicine.

Adequate nutrition

Infants with a larger VSD may get tired when feeding. They may not be able to eat enough to gain weight. They may need:

  • High-calorie formula or breastmilk. Your child may need nutritional supplements added to his or her formula or pumped breastmilk. This increases the number of calories in each ounce.
  • Supplemental tube feedings. Your child may need to be fed through a small, flexible tube. This tube passes through the nose, down the esophagus, and into the stomach. Your child may have tube feedings along with or in place of bottle feedings. Infants who can drink part of their bottles may be fed the rest through a feeding tube. Infants who are too tired to bottle-feed may get all of their nutrition through the feeding tube.

Surgery

The goal of surgery is to repair the septal opening before the lungs are damaged. Surgery will also help infants who have trouble feeding gain a normal amount of weight. Your child's heart doctor will decide when your child should have surgery. This may be based on echocardiogram and cardiac catheterization results.

In surgery, your child’s doctor will close the VSD with stitches or a special patch. Ask your child’s heart doctor for more information.

Cardiac catheterization

VSD may be repaired by a cardiac catheterization. In this test, an instrument called a septal occluder is used with a catheter. The healthcare provider guides the catheter through the blood vessels to the heart. Once the catheter is in the heart, the doctor uses the septal occluder to close the defect.

What are the complications of a VSD?

Complications of an untreated VSD include:

  • Lung problems
  • Heart failure
  • Irregular heart rhythms (arrhythmias)
  • Heart valve problems
  • Poor growth and development

Living with a VSD

Small VSDs

Infants with small VSDs may have no symptoms. These children may not need medicine. They’ll still be checked often by their heart doctors. If a defect is going to close, it usually happens by 2 years of age. But some defects don’t close until 4 years of age. These children usually grow and develop normally. They also have no activity restrictions, and live normal, healthy lives.

Moderate to severe VSDs

If the VSD is moderate to severe, your child’s heart doctor will closely monitor him or her. The doctor will decide when and how your child’s VSD will be fixed. Before surgery, your child may need medicine and special feedings. Your child's healthcare team will give you information and support so you can care for your child at home. Children who need surgery will be admitted to the hospital for surgery.

Babies who have trouble eating before surgery often have more energy right after surgery. They start to eat better and gain weight faster.

After surgery, older children can often be active without getting too tired. Within a few weeks, your child should be fully recovered. He or she should be able to do normal activities. Your child’s healthcare team may give you instructions on how to care for your child.  

Most children who have surgery for VSD will live normal, healthy lives. Their activity levels, appetite, and growth often return to normal. Your child's heart doctor may give him or her antibiotics to prevent infections after leaving the hospital.

Ask your child's healthcare provider about your child’s outlook. When this condition is diagnosed early, the outcome is often excellent. When a VSD is diagnosed later in life, if complications occur after surgery, or if the VSD isn’t repaired, the outlook may be poor. There is a risk for complications from a VSD. Children at risk for these problems should have follow-up care at a center that specializes in congenital heart disease.

When should I call my child's healthcare provider?

If your child has trouble breathing or eating, or develops any new symptoms, call his or her healthcare provider.

Key points about VSD

  • A VSD is an opening in the dividing wall between the two lower chambers of the heart.
  • The size of the opening affects how severe your child’s symptoms are.
  • Small VSDs may close on their as your child grows. If your child has a larger VSD, he or she will likely need surgery or a cardiac catheterization to fix it.
  • Most children whose defects close on their own or who have VSD repairs will live normal, healthy lives.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

  • Know the reason for the visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
  • Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
  • Ask if your child’s condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if your child does not take the medicine or have the test or procedure.
  • If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.

 

Atrial Septal Defect (ASD)

What is an atrial septal defect?

The atrial septum is the wall between the two upper chambers of the heart (right and left atria). An atrial septal defect (ASD) is an abnormal hole in this wall. ASD is a heart problem that is present at birth (congenital).

ASDs can happen on their own. Or they can happen in children born with other congenital heart defects. Girls have ADS twice as often as boys. Doctors don't know why this is.

What causes an atrial septal defect?

The heart forms during the first 8 weeks of pregnancy. It starts as a hollow tube and divides into 4 chambers. These chambers are separated by walls (septa). It's nornal for the walls to have openings as the fetus grows. The openings usually close shortly before or just after birth. If they don't all close, the atrial septum will have a hole in it. This is called an ASD.

Some congenital heart defects may be passed down in certain families. Most atrial septal defects occur by chance. Doctors can find no clear reason that they occurred.

What are the symptoms of an atrial septal defect?

Many children have no symptoms and seem healthy. If the ASD is large, your child may have symptoms. Your child may:

  • Tire easily
  • Have fast breathing
  • Have shortness of breath
  • Grow slowly
  • Have respiratory infections often

The symptoms of ASD can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

How is an atrial septal defect diagnosed?

Your child's healthcare provider  may have heard a heart murmur when listening to your child's heart with a stethoscope. The heart murmur is from the abnormal flow of blood through the heart.

Your child may need to see a pediatric cardiologist for a diagnosis. This is a doctor with special training to treat heart problems in children. The doctor will examine your child and listen to your child's heart and lungs. The doctor will find out where the murmur is best heard and how loud it is. Your child may have some tests, such as:

  • Chest X-ray. This test may show an enlarged heart. Or it may show changes in your child's lungs because of the blood flow changes caused by an ASD. 
  • Electrocardiogram (ECG). This test records the electrical activity of the heart. It shows abnormal rhythms (arrhythmias) that may be caused by an ASD. It can also find heart muscle stress caused by an ASD.
  • Echocardiogram (echo). This test uses sound waves to make a moving picture of the heart and heart valves. An echo can show the blood flow through the atrial septal opening and find out how big the opening is.
  • Cardiac catheterization. This tests uses a thin, flexible tube (catheter) put near the heart. Contrast dye is used to get even clearer pictures. In some children, this procedure may be used to close the ASD.

How is an atrial septal defect treated?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. The most common type of ASD may close on its own as your child grows.

Once an atrial septal defect is diagnosed, your child's cardiologist will check your child to see if the defect is closing on its own. An ASD will usually be fixed if it has not closed by the time a child starts school. The decision to close the ASD may also depend on the size of the defect.

Treatment may include:

  • Medicine. Many children have no symptoms and don't need medicine. But medicine can help some children's hearts work better. For example, water pills (diuretics) help the kidneys get rid of extra fluid from the body.
  • Surgery. Your child's ASD may be repaired by surgery. The surgery is done under general anesthesia. The defect may be closed with stitches or a special patch.
  • Device closure. Some children are helped with this procedure. The doctor uses cardiac catheterization to put a special device (septal occluder) in the open ASD. The device stops blood from flowing through the ASD.

What are the complications of an atrial septal defect?

Large ASDs may cause lung problems over time if not treated. This is because the extra blood passing through the defect and then into the lungs may harm the vessels in the lungs.

Living with an atrial septal defect

All children with an ASD need to be cared for by a pediatric cardiologist. Most children who have had an ASD repair will live healthy lives. After the repair, your child's doctor may want your child to take antibiotics. This will prevent an infection of the heart lining (bacterial endocarditis).

With early diagnosis and repair of an ASD, children usually do very well. They don't need much follow-up care. Children are more likely to have problems if an ASD is diagnosed later in life and never repaired. Or they may have problems if complications occur after closing the defect. 

Some children develop high blood pressure in the lungs (pulmonary hypertension). These children should have follow-up care at a center that specializes in congenital heart disease.

Talk with your child's healthcare provider about the outlook for your child. 

When should I call my child's healthcare provider?

Call your child's healthcare provider if your child has new symptoms or symptoms that get worse. Symptoms may include:

  • Tiredness that gets worse
  • Troubled breathing
  • Fast breathing

Key points about atrial septal defect

  • An atrial septal defect is an opening in the wall dividing the two upper chamber of the heart.
  • Symptoms of an atrial septum defect include tiring easily, fast breathing, shortness of breath, poor growth, and respiratory infections that happen often.
  • Atrial septum defects range from small to large.
  • Small atrial septum defects may close on their own.
  • Atrial septum defects that are large or cause symptoms can be repaired.
  • Most children who have had an atrial septal defect repair will live healthy lives. 

Next steps

Tips to help you get the most from a visit to your child’s health care provider:

  • Before your visit, write down questions you want answered.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you for your child.
  • If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.

Providers

David A. Bull, M.D.

Patient Rating:

4.8

4.8 out of 5

David Bull, MD, is a member of the Thoracic Oncology Program, a joint effort between Huntsman Cancer Institute and the University of Utah Hospitals and Clinics. The program was developed to offer consultation, diagnosis, and treatment for all chest cancers. Bull is a professor in the Department of Surgery, Division of Cardiothoracic Surgery; progra... Read More

Phillip T. Burch, M.D.

Dr. Burch performs repairs for a wide variety of congenital cardaic anomalies. In additon to clinical responsibilities, Dr. Burch has research interests in single ventricle physiology as well as in derangements in normal neonatal metabolism caused by cardiac surgery.... Read More

Specialties:

Cardiothoracic Surgery, Pediatric Cardiothoracic Surgery

Locations:

Primary Children's Hospital (801) 662-5577

Aaron W. Eckhauser, M.D., M.S.C.I

I joined the University of Utah, Division of Pediatric Cardiothoracic Surgery in 2012. I am board certified by the American Board of Surgery and the American Board of Thoracic Surgery. My clinical interests are focused on caring for all patients, from neonates to adults, with congenital heart defects. I have a special interest in pediatric heart... Read More

Specialties:

Cardiac Mechanical Support, Cardiothoracic Surgery, Heart Transplant, Pediatric Cardiothoracic Surgery

Locations:

A location has not yet been added by this physician.

Specialties:

Cardiothoracic Surgery

Locations:

A location has not yet been added by this physician.

Specialties:

Cardiothoracic Surgery

Locations:

A location has not yet been added by this physician.

Ganesh S. Kumpati, M.D.

Dr Kumpati performs adult cardiac surgery, thoracic surgery, and vascular surgery. Dr Kumpati has significant experience in both surgical and endovascular management of aortic disease, including endovascular aneurysm repair. Prior to joining the University of Utah in August 2011, Dr Kumpati was in private practice in Milwaukee, Wisconsin, for 5 y... Read More

Specialties:

Cardiothoracic Surgery

Locations:

University Hospital
Cardiovascular Center
(801) 581-5311
Veterans Administration Medical Center (801) 582-1565

Stephen McKellar, M.D., M.Sc.

Dr. McKellar is a native of Salt Lake City and received his Bachelor of Arts from the University of Utah and his Doctor of Medicine from the George Washington University School of Medicine. He completed his General Surgical and Cardiothoracic Surgical training at the Mayo Clinic in Rochester, Minnesota in a combined, integrated training program. ... Read More

Amit N. Patel, M.D.

Patient Rating:

4.9

4.9 out of 5

Amit Patel, MD, MS, is an associate professor in the Division of Cardiothoracic Surgery at the University of Utah School of Medicine and Director of Clinical Regenerative Medicine and Tissue Engineering at the University of Utah. His clinical interests include heart surgery for coronary disease, valve repair and replacement, heart failure, aortic s... Read More

Craig H. Selzman, M.D.

Patient Rating:

4.9

4.9 out of 5

Dr. Craig Selzman is a Professor of Surgery and Chief of the Division of Cardiothoracic Surgery at the University of Utah who specializes in the care of patients requiring heart surgery. He earned his undergraduate degree at Amherst College and medical degree at Baylor College of Medicine. He received his General and Cardiothoracic Surgery training... Read More

Thomas K. Varghese Jr., M.D., M.S.

Thomas Varghese Jr. MD, MS has specialized expertise in the treatment of diseases of the lungs, esophagus, chest wall and mediastinum. He is board certified in both Surgery and Thoracic Surgery. His main clinical focus is in the use of minimally invasive surgery in the management of patients with tumors in the chest. He has integrated a health serv... Read More

Specialties:

Cardiothoracic Surgery, Nurse Practitioner

Locations:

Eccles Primary Children’s Outpatient Services Building (801) 662-1000
University Hospital
Cardiovascular Center
(801) 581-0434

Specialties:

Cardiothoracic Surgery, Physician Assistant

Locations:

A location has not yet been added by this physician.

Specialties:

Cardiothoracic Surgery, Perfusionist

Locations:

A location has not yet been added by this physician.

Specialties:

Cardiothoracic Surgery

Locations:

University Hospital
Cardiovascular Center
(801) 213-2200

Nathan C. Sontum, PA-C, M.H.S.

PA-C for department of CT surgery 2010-Present... Read More

Specialties:

Cardiothoracic Surgery

Locations:

A location has not yet been added by this physician.

Specialties:

Cardiothoracic Surgery

Locations:

A location has not yet been added by this physician.

Scott A. Tatum, PA-C

Scott came to the University over 6 years ago from private practice. As a trainer and consultant for Endoscopic Vein harvesting, he has effectively introduced and incorporated new technology and procedures into the University healthcare system. As the senior physician assistant in the division of cardiothoracic surgery, Scott has over twelve year... Read More

Specialties:

Cardiothoracic Surgery, Physician Assistant

Locations:

University Hospital (801) 581-2121

Locations

University Campus
University Hospital
50 N Medical Drive
Salt Lake City, UT 84132
Map
(801) 581-2121
Primary Children's Hospital
100 N Mario Capecchi Dr
Salt Lake City, UT 84132
(801) 662-1000
Veterans Administration Medical Center
500 Foothill Drive
Salt Lake City, UT 84148
(801) 582-1565