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Wednesday, 4 March 2015

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How to Diagnose VSD?

How to Diagnose VSD?


What is a ventricular septal defect?

 A ventricular septal defect (VSD), sometimes known as a hole in the heart, is a common congenital abnormality. The hole (defect) develops in the wall (septum) that divides the lower chambers of the heart, which are the pumping chambers (ventricles).

The defect permits blood to flow from the left side of the heart to the right side. The oxygen-rich blood is then pushed back to the lungs rather than the rest of the body, causing the lungs to become congested (difficult to breathe) and the heart to work harder.

A minor ventricular septal defect may not raise any issues, and many of them heal on their own. Because medium and larger VSDs may not close on their own, they may need surgical treatment early in childhood to avoid problems.

What are the Symptoms?

Signs and symptoms of major VSD often arise in the first few weeks or months of a child's life.

  • A baby's symptoms may include: poor feeding, failure to thrive

  • Breathing too quickly or too slowly

 

If the abnormality is minor, symptoms may not manifest until later in life, if at all. The signs and symptoms may differ depending on the size of the hole and underlying cardiac abnormalities.

During a routine heart check, your doctor may suspect a heart abnormality if he or she hears a murmur when listening to your baby's chest. Adults may be diagnosed with a minor VSD.

 

What are the Causes of VSD?

A VSD arises when the muscle wall dividing the heart's left and right ventricles fails to form entirely during fetal development.

A VSD permits oxygenated blood to be pumped back to the lungs, leading the lungs to become clogged from receiving too much blood, but also depriving the body of the full flow, resulting in shortness of breath and exhaustion.

VSDs appear in a range of diameters and may be found in a variety of sites in the wall between the ventricles. There may be one or more VSD.

 

What are the Complications of VSD?

A small ventricular septal defect may never cause any issues, however, bigger flaws might result in a variety of difficulties.

Heart failure. Heart failure may occur a few weeks after birth and is often treated with anti-failure drugs such as diuretics and/or Ace Inhibitors.

Hypertension of the lungs. Increased pulmonary blood flow caused by the VSD may result in high blood pressure in the lung arteries (pulmonary hypertension), especially if diagnosis and therapy are delayed. Most of the time, it is a temporary issue that resolves after the VSD is closed. Pulmonary hypertension may be a devastating consequence of long-standing, untreated VSD, resulting in the reversal of blood flow through the hole (Eisenmenger syndrome).

Endocarditis. This heart infection is a rare consequence in children, but it is more prevalent in adults with untreated VSD.

Other cardiac issues include irregular heartbeats and valve issues.

How to Diagnose VSD?

If your doctor suspects a VSD, hears a heart murmur or notices other signs or symptoms of a heart defect, he or she may request various tests, including:

Chest X-ray. The doctor can see the heart and lungs better with the use of X-ray imaging. This may assist physicians in determining if the heart is enlarged and whether the lungs contain excess fluid.

Cardiac catheterization. A thin, flexible tube (catheter) is placed into a blood artery in the groin or arm and directed through the blood vessels into the heart during this examination. Doctors may use cardiac catheterization to identify congenital heart abnormalities and assess the function of the heart's valves and chambers.

Echocardiogram. Sound waves from a video picture of the heart in this test. This test may help doctors detect a ventricular septal defect and establish its size, location, and severity. It may also be used to rule out any other cardiac abnormalities. A fetus may be subjected to echocardiography (fetal echocardiography).

Electrocardiogram (ECG). This test uses electrodes connected to the skin to capture the electrical activity of the heart and aids in the diagnosis of heart abnormalities or rhythm disorders.

Pulse oximetry. The quantity of oxygen in the blood is measured using a tiny clip on the fingertip.

What is the Treatment for VSD?

Many newborns born with a minor ventricular septal defect (VSD) will not need surgery to seal the hole. Your doctor may want to monitor your baby and treat symptoms after delivery while waiting to see whether the abnormality resolves on its own.

Babies that need surgical repair are often operated on within their first year. Children and adults with medium or large ventricular septal defects, especially those producing considerable symptoms, may need surgery to seal the defect.

Some minor ventricular septal defects are surgically corrected to avoid issues linked to their location, such as heart valve injury. Many persons with minor VSDs enjoy productive lives with few complications.

Babies with big VSDs or who fatigue quickly while feeding may need more nutrients to thrive. Some babies may require tube feeding.

 

Medications

Medications for ventricular septal defects may include those that: reduce the quantity of fluid in circulation and the lungs. This decreases the amount of blood that needs to be pumped. 

 

Procedures

Ventricular septal defects are treated surgically by closing or repairing the aberrant hole between the ventricles. If you or your kid needs surgery to fix a ventricular defect, consider having it done by surgeons and cardiologists who have received training and skill in performing these operations. Procedures may include the following:

Surgical intervention. In most situations, this treatment of choice entails open-heart surgery under general anaesthetic. The procedure necessitates the use of a heart-lung machine as well as a chest incision. To seal the hole, the doctor applies a patch or stitches.

Catheter insertion. It is not necessary to open the chest to close a ventricular septal defect during catheterization. Rather, the doctor passes a tiny tube (catheter) through a blood artery in the groyne to the heart. The doctor next closes the opening with a specially sized mesh device.

 

Procedural hybridization. A hybrid procedure combines surgical and catheter-based methods. Access to the heart is normally gained with a tiny incision, and the surgery may be carried out without stopping the heart or utilizing a heart-lung machine. A tube introduced through the incision is used to seal the ventricular septal defect using a device.

 

Following repair, your doctor will arrange frequent medical follow-up appointments to verify that the ventricular septal defect is closed and to check for symptoms of problems. Your doctor will inform you how often you or your kid will need to be visited based on the magnitude of the deformity and the existence of associated disorders.

 

Lifestyle and home remedies

Following the correction of your ventricular septal defect (VSD), you or your kid will need follow-up treatment for the rest of your life in order for specialists to monitor your health and look for symptoms of problems.

 

Your doctor may recommend that you or your kid have frequent follow-up consultations with a congenital heart disease specialist. Your doctor may examine you or your kid during follow-up sessions and request imaging tests to monitor your or your child's health.

 

Here are some pointers for dealing with your or your child's condition:

  • Take pregnancy seriously. Before getting pregnant, consult with a specialist who specializes in heart issues (cardiologist) to evaluate whether the pregnancy is safe for you. This is particularly critical if you are taking drugs. During pregnancy, it's also critical to visit both an obstetrician and a cardiologist.
  • A corrected VSD with no problems or a minor defect does not represent an extra pregnancy risk. An unrepaired, bigger defect; heart failure; pulmonary hypertension; irregular heart rhythms; or other cardiac abnormalities, on the other hand, offer a substantial danger to both mother and baby. Because of the significant potential of problems, doctors strongly encourage women with Eisenmenger syndrome not to get pregnant.
  • Endocarditis should be avoided. Antibiotics are typically not required before some dental treatments to avoid an infection of the heart's inner lining (endocarditis).
  • However, if you've had prior endocarditis, a heart valve replacement, a recent VSD repair with artificial material, if you still have leaked through the VSD, if the repaired VSD is next to a defect that's been repaired with artificial material, or if you have a large ventricular septal defect causing low oxygen levels, your doctor may recommend antibiotics.
  • Good oral hygiene and frequent dental check-ups may help most persons with a ventricular septal defect avoid endocarditis.
  • Adhere to exercise suggestions. Your doctor can tell you which activities are risk-free for you or your kid. Encourage your youngster to participate in the alternative, safer activities if certain activities offer unique hazards. Remember that many children with VSDs may have healthy, active, and productive lives.
  • Children with minor cardiac abnormalities or a repaired hole in the heart normally have few or no limits on their activities or exercise. Children whose hearts do not pump regularly may need to adhere to certain restrictions. A child with irreversible pulmonary hypertension (Eisenmenger syndrome) faces the most restrictions.

 


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