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 Chen Tian Hua
Cardiology
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What are the complications of ventricular septal defect?

The complications of ventricular septal defect mainly include the following: 1. Causes infective endocarditis, with the highest incidence occurring between the ages of 15 and 29; 2. Leads to aortic valve insufficiency; 3. Causes conductive blockages; 4. Leads to heart failure, and can even lead to Eisenmenger syndrome. Therefore, patients with ventricular septal defects should actively complete examinations such as echocardiography. If there are indications for surgery, they should promptly visit a cardiac surgeon for active surgical treatment to correct the anatomical abnormalities of the ventricular septal defect and prevent the condition from worsening and leading to serious consequences.

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Written by Chen Tian Hua
Cardiology
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Can a ventricular septal defect heal by itself?

Some ventricular septal defects can heal on their own. For ventricular septal defects smaller than five millimeters, some patients can heal on their own; the defects that generally heal are those in the membranous and muscular parts of the septum, and the younger the age, the greater the likelihood of healing. If the ventricular septal defect still exists after the age of five, it generally cannot heal on its own. For ventricular septal defects that do not heal spontaneously, if they significantly affect hemodynamics, interventional treatment or surgical surgery is needed for repair. If the impact of the ventricular septal defect on hemodynamics is not significant, regular follow-up examinations can be conducted to understand the condition of the disease.

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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 Xie Zhi Hong
Cardiology
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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.

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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.