Ventricular septal defect

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Written by Di Zhi Yong
Cardiology
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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.

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Written by Di Zhi Yong
Cardiology
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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.

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Written by Xie Zhi Hong
Cardiology
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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.

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Written by Di Zhi Yong
Cardiology
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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.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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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.

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Written by Di Zhi Yong
Cardiology
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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.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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The difference between ventricular septal defect and atrial septal defect

The difference between a ventricular septal defect and an atrial septal defect mainly lies in their locations. A normal heart is divided into four chambers, which are the left ventricle, right ventricle, left atrium, and right atrium. Each chamber is separated by a septum, much like walls between rooms in a house. Due to certain reasons, such as congenital heart defects, there may be openings or defects in these walls, known as septal defects. An atrial septal defect refers to a defect between the right atrium and the left atrium, whereas a ventricular septal defect pertains to a defect between the left and right ventricles. The murmur of atrial septal defects is relatively softer, as the pressure difference between the atria is smaller, and the defect is located higher up. In contrast, the murmur of ventricular septal defects is louder due to the greater pressure difference between the ventricles and is located lower down, approximately between the third and fourth ribs. The murmur of atrial septal defects is found between the second and third ribs. Moreover, since the pressure difference in ventricular septal defects is greater, the impact on the heart is relatively more significant.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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What are the symptoms of ventricular septal defect?

What are the symptoms of a ventricular septal defect? In normal individuals, there are no defects between the ventricular septa. However, if there is a small ventricular septal defect, such as less than five millimeters, typically ranging between two to three millimeters, this minor defect functions like small gaps between normal windows and doors, causing minimal shunting which generally does not significantly impact the patient, resulting in no obvious symptoms. However, if the defect is relatively large, such as exceeding five millimeters, causing significant left ventricular blood to shunt to the right ventricle, it can lead to congestion in the right ventricular system or pulmonary circulation. Under such conditions, patients may frequently experience respiratory infections, congestive heart failure, or in children, reluctance to eat, presenting feeding difficulties and developmental delays. Of course, if the defect continues to enlarge, achieving a size larger than the patient's aorta, the patient may show signs of significant right heart failure due to the damaged ventricular septum, necessitating emergency surgical intervention.

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Written by Di Zhi Yong
Cardiology
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What should be noted for an atrial septal defect with patent foramen ovale?

If the patient presents with a ventricular septal defect or a patent foramen ovale, it is important to maintain a healthy diet and particularly to prevent upper respiratory infections, as these conditions are types of congenital heart disease. They mainly lead to repeated respiratory infections, cyanosis, or lung infections, resulting in changes associated with congenital heart disease. For a ventricular septal defect, early surgical intervention is currently recommended. Patent foramen ovale is also treated surgically. During this period, it is important to monitor changes in the child's height and weight, as such diseases can affect the child's growth and development.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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Interventricular septal defect X-ray manifestation

X-ray Manifestations of Ventricular Septal Defect. These are mainly related to the size of the defect. If the ventricular septal defect is relatively small, for example less than three millimeters, the amount of blood shunted from the left ventricle to the right ventricular system is minimal. Consequently, right ventricular congestion is not pronounced, making pulmonary congestion also less obvious. At this point, the X-ray may show no significant changes. However, if the defect is larger, greater than three millimeters, for instance five millimeters, a large volume of high-pressure blood from the left ventricle will flow excessively through the defect into the right ventricular system. This leads to significant congestion in the right ventricle and, thus, in the entire pulmonary circulation. Additionally, the X-ray will show a prominent pulmonary artery segment and increased pulmonary blood flow. Moreover, over time, this condition may lead to compensatory enlargement of the left ventricular system. On the X-ray, enlargement of both the right and left ventricles can be observed. Furthermore, due to sustained high pressure, the distal pulmonary arteries may show signs of severe pulmonary vascular disease on the X-ray, resembling a broken book. This indicates that the pulmonary circulation has reached an end-stage condition.