Ventricular Septal Defect is a congenital heart anomaly characterized by a hole in the wall (or septum) separating the lower chambers of the heart or the ventricles. This causes oxygen-rich blood to travel back to the lungs rather than be pumped out to the entire body.
Notes on VSD:
- Each year, there are about 42 babies from 10,000 babies born who have VSD in the United States.
- The cause is still unknown.
- The muscular wall separating the left and right sides of the heart failed to fully form, especially on the lower chambers (ventricles).
- Oxygenated blood mixes with deoxygenated blood. This in turn shoots up the pressure and the blood flow in the arteries of the lungs.
- Comes in various sizes and locations.
- Different names of Ventricular Septal Defect (VSD) based on locations:
- Conoventricular VSD – the hole is located below the pulmonary valve and the aortic valve
- Perimembranous VSD – the hole is located just above the ventricular septum
- Inlet VSD – the hole in the wall, between the left and right ventricle, is near the area where the blood enters the ventricle that passes the tricuspid valve and the mitral valve. This can also be associated with AVSD (atrioventricular septal defect).
- Muscular VSD – the hole is located in the lower and muscular part of the ventricle. This type is the common VSD.
Risk Factors and Causes
- Unknown cause
- Chromosome change
- Mother’s exposure to drugs and the environment
- Genetic problem – Down syndrome
Diagnosis
- Echocardiogram
- Auscultation (listen for heart murmur)
Signs and Symptoms
- Shortness of breath
- Breathing is faster than normal
- Sweats most of the time
- Feeding is tiresome for the child
- Weight gain is very poor
- Easily exhausted especially when playing
- Weakness and fatigue
Treatment
- Medications – the goal is to lessen the amount of fluid in the lungs and in the circulation. Diuretics, like furosemide (Lasix), reduce the amount of blood pumped.
- Heart surgery
- Cardiac catheterization
Nursing Interventions
The first thing to do is to assess the child’s ability to perform activities of daily living (ADL).
Monitor the extent of dyspnea when exerting and the color of the skin when resting or while playing.
- Allow plenty of rest.
- Do not allow infants to cry for a long period of time. For feeding, you may educate the parents to use soft nipples. If the infant has trouble eating, may gavage-feed the infant.
- Take extra precautions while bathing the infant. The temperature should be checked before plunging the baby into the water. Cover the areas that you don’t need to clean to avoid infants losing heat.
- You may provide toys and play games as a diversion as appropriate to the child’s condition. Limit physical activity games. Board games will do.
- Help the parents in planning care for children with VSD, and the periods of rest.
- Limits for exercise and activity are instructed to the parents when caring for infants with VSD.
- Consult a physician when symptoms and signs worsen.
