Is perimembranous ventricular septal defect serious?

Written by Xie Zhi Hong
Cardiology
Updated on September 27, 2024
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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.

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Written by Xie Zhi Hong
Cardiology
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What should I do about hypoxia due to a ventricular septal defect?

Mild ventricular septal defects generally do not cause hypoxia. If symptoms of hypoxia recur due to a ventricular septal defect, it is recommended to undergo minimally invasive interventional treatment or surgical treatment at a hospital to prevent further episodes. The success rate of this surgery is very high, almost 100%, with relatively few complications. If hypoxia occurs in untreated ventricular septal defects, initial therapy should include oxygen administration, followed by diuretic, cardiotonic, and other treatments to reduce cardiac load at a hospital, and surgery should be considered as soon as suitable.

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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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What would happen if the ventricular septal defect occluder dislodges?

An occluder generally works like two umbrella surfaces clamped over the orifice of the interventricular septal defect, achieving the method whereby tissue blood flow enters from the left side of the septum to the right side. Once an occluder dislodges, it can lead to a dangerous situation, as the occluder has a membrane that can easily get caught on the tendons of the mitral valve, causing severe mitral regurgitation; it can also get stuck at the mitral valve orifice, obstructing the outflow of blood; it may also lead to aortic valve insufficiency; if it gets caught in the major arteries, it can cause arterial embolism, leading to sudden death in the patient. Therefore, the dislodgement of an occluder is a very dangerous phenomenon.

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Written by Fan Yan Fu
Cardiology
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Can someone with a ventricular septal defect travel by airplane?

Generally, individuals with ventricular septal defects (VSD) with no complications do not display symptoms and are able to travel by airplane. When such defects are at an early stage, where cardiac function has not been significantly impaired and there is left-to-right shunting without heart failure or pulmonary hypertension, flying is generally tolerated. After surgery for a ventricular septal defect, patients usually can fly. However, if the patient with a ventricular septal defect is older and in the advanced stages of the condition, exhibiting clear symptoms of heart failure such as difficulty breathing and chest tightness with significant exertional stress, such patients are unable to lie down and should not fly. Additionally, if there is right-to-left shunting or severe pulmonary hypertension has developed, it is unsafe for them to fly as they could potentially face emergencies during the flight.

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Written by Di Zhi Yong
Cardiology
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Does a ventricular septal defect easily cause hiccups in infants?

The relationship between the two is not very significant. A ventricular septal defect is a type of congenital disease, and currently, surgical treatment is recommended for patients, as medical treatment is not very effective and prone to relapse. For this type of congenital heart disease, it is best to first perform a cardiac echocardiography to make a clear diagnosis. In terms of treatment, early surgical intervention is suggested for patients to thoroughly improve symptoms such as palpitations, chest tightness, and difficulty in breathing. If an infant often experiences hiccupping, it could be a sign that the infant's stomach is not very mature, leading to excessive stomach acid, but this is not significantly related to the ventricular septal defect.