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Ventricular septal defect
Does interventricular septal defect occasionally cause chest pain?
Ventricular septal defect is a type of congenital heart disease, occurring when the ventricles of the heart develop poorly during the embryonic stage, leading to a defect in the ventricular septum. This often results in a left-to-right shunt which affects the efficiency of the heart's function. In severe cases, it can cause a right-to-left shunt. Generally, these conditions do not affect the coronary circulation or cause chest pain in patients. However, some patients may develop endocarditis at the ventricular septum, which sometimes leads to the formation of vegetations on the cardiac valves or blood clots on the abdominal wall. If thrombosis or vegetations occur, there is a possibility of these breaking off. If they enter the coronary arteries, they can cause chest pain. However, such events are extremely rare, with an occurrence rate of less than one in a thousand.
Symptoms of ventricular septal defect
The main symptoms of a ventricular septal defect depend on the size of the defect and the age of the patient. Generally, smaller ventricular septal defects, such as those measuring only one to two millimeters, result in very little shunting from the left ventricular system to the right ventricular system. This is akin to a tiny amount of air seeping through a crack in a window or door. In such cases, the patient typically does not exhibit noticeable symptoms. However, if the defect is larger, over five millimeters, a significant amount of blood passes from the left ventricular system into the right ventricular system, which can cause substantial congestion in the right or both lungs of the right ventricular system, or lead to recurrent respiratory infections and congestive heart failure. The affected individual may show disinterest in eating, feeding difficulties, and delayed development. As the patient grows older, they may exhibit reduced activity endurance, fatigue or palpitations, and shortness of breath. Gradually, cyanosis and right heart failure may develop. Additionally, patients are at risk of developing infective endocarditis, fever without symptoms, and recurring fever.
Is perimembranous ventricular septal defect serious?
The ventricles are separated by the interventricular septum, which divides the left and right ventricles. Typically, after blood is ejected from the left ventricle and oxygenated by tissues, it returns to the right ventricle. The blood from the right ventricle gets oxygenated through the pulmonary artery before it can return to the left ventricle. These two should be isolated from each other before passing through the lungs. The interventricular septum consists of the membranous and muscular parts, and a defect in either part can affect oxygenation. Therefore, whether the defect is in the membranous or muscular portion is not an indicator for diagnosing the severity of the interventricular septum defect; rather, the size of the defect should be considered. Generally speaking, a defect of about 10mm in the interventricular septum, especially when accompanied by other conditions such as Tetralogy of Fallot, is considered severe. Moreover, when the defect reaches over 10mm, surgical intervention is required as minimally invasive surgery would not be feasible; these are considered severe interventricular septum defects. Also, there are cases with multiple complex defects or larger defects that should be surgically treated as soon as possible.
Can ventricular septal defect avoid amniocentesis?
Because ventricular septal defect is a type of congenital heart disease, it is recommended that patients adopt a light diet and especially avoid spicy and stimulating foods due to the condition of ventricular septal defects. It is still recommended to pursue active and early surgical treatment to improve symptoms. If there is poor cardiac function, or symptoms of palpitations and chest tightness occur, amniocentesis should not be performed as it carries certain risks. However, for milder symptoms that can be timely controlled, amniocentesis and other tests may be considered, but it is also necessary to rule out other diseases. If the patient does not have any special diseases in the past, such as coronary heart disease or diabetes, the procedure can be handled.
Can a ventricular septal defect be detected with a regular ultrasound?
Ventricular septal defect is a type of congenital heart disease, and surgical treatment is recommended for patients. Currently, to diagnose this condition, it is advised that patients undergo a cardiac echocardiography rather than just a standard ultrasound, which does not show clear results. Color Doppler ultrasound is the best way to make an accurate diagnosis and therefore determine the appropriate treatment plan. It is possible to see the size and location of the ventricular septal defect, which can significantly aid the treatment planning. Standard ultrasound may not provide a clear view and can sometimes lead to discrepancies, making treatment challenging. During this period, regular follow-up with cardiac echocardiography is still necessary, and early surgery is recommended for patients.
Can ventricular septal defect be detected during prenatal screening?
Ventricular septal defect is a type of congenital heart disease that can only be diagnosed through an echocardiogram. Routine prenatal screenings cannot detect it. Particularly for newborns, it’s advisable to have an echocardiogram, and for fetuses, a four-dimensional ultrasound is recommended. Sometimes, ultrasound results can only serve as a reference and may not indicate actual problems, but there is also a certain margin of error. If a child has congenital heart disease, it is advisable to have regular echocardiogram check-ups at the hospital. This allows timely identification of the cause, and determination of whether surgery is necessary for treatment, which is the ultimate goal.
Will being overweight affect the surgery for a ventricular septal defect?
Ventricular septal defect surgery is performed by puncturing the right femoral vein, guiding the catheter into the inferior vena cava, through the atria and ventricles, and reaching the defect via the right ventricle. The occluder can then be delivered through the catheter into the left ventricle, where the umbrella is opened, followed by opening it in the right ventricle; this describes the surgical process. Therefore, generally speaking, the surgical process is not affected in most patients who are obese. However, severe obesity can impact the accuracy of vascular localization during puncture by the surgeon. Secondly, if complications such as anesthesia issues or other emergencies arise during the surgery, severely obese patients may experience a reduced success rate in emergency surgical interventions, hence it is recommended that patients control their weight. Furthermore, severe obesity can exacerbate the cardiac load originally induced by the ventricular septal defect, thus affecting the surgical tolerance in patients whose cardiac function is already compromised by the defect. It is recommended that these patients control their weight.
If a ventricular septal defect is not surgically repaired, what will happen?
If the patient has a history of congenital heart disease, especially ventricular septal defect, it can lead to symptoms such as palpitations and chest tightness. The current recommendation for treatment is primarily symptomatic management; however, it is also advised that patients seek early surgical intervention at a hospital. Medical treatment or drug therapy often does not yield ideal results for this condition, and surgical intervention is necessary to address these symptoms. Currently, minimally invasive surgical treatment can be used. If the patient does not undergo surgery, conditions such as palpitations, chest tightness, and difficulty breathing can occur at any time.
Ventricular septal defect refers to a defect in the ventricular septum, the wall dividing the left and right ventricles of the heart.
A normal human heart is divided into four chambers: the left ventricle, right ventricle, left atrium, and right atrium. The circulation in a normal person involves venous blood entering the right atrium, passing through the mitral valve into the right ventricle. The right ventricle then contracts and pumps blood into the lungs. After exchanging gases and becoming oxygenated, the blood turns bright red. It then returns to the left atrium. From the left atrium, blood passes through the mitral valve back into the left ventricle, and then the left ventricle contracts and pumps blood throughout the body. Therefore, there is a thick wall between the normal left and right ventricles, known as the ventricular septum. If due to congenital heart disease or other reasons, a small hole appears in the ventricular septum, it is called a ventricular septal defect. If this defect is large, it necessitates active surgical treatment because if the defect exists, the pressure of the blood flow in the left ventricle is higher, causing a large amount of abnormal blood to enter the right ventricle. This leads to a significant accumulation of blood in the right ventricle, causing the patient to have too much blood in the pulmonary circulation, making the patient prone to recurrent colds and infections. Furthermore, these children may easily develop heart failure and even life-threatening conditions such as infective endocarditis.
Which is more serious, patent ductus arteriosus or ventricular septal defect?
Both of these diseases are types of congenital heart disease, and if there are issues with either of them, the situation can be quite severe. There isn't a distinction between which disease is severe and which is not. If the arterial duct remains open or does not close, surgery is still required for this condition. Patients with ventricular septal defect primarily display changes related to ischemia and hypoxia, and they may also experience recurrent respiratory infections, which are quite serious. Surgery is generally the best treatment. Early surgical intervention can achieve a complete cure, but it is also advisable for the patient to have regular echocardiographic check-ups at the hospital.