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Septal Defects in Children

The human heart has four chambers. The two upper chambers of the heart are called the left and right atrium and the two lower chambers of the heart are called the right and left ventricular. A septal defect is a congenital abnormality in the septum between the left and right sides of the heart.

  1. Ventricular Septal Defects

    • A gap between the right and left chambers of the heart is called a ventricular septal defect (VSD). In a heart, the right and left chambers are divided by the septum. The right ventricle is divided from the left ventricle by the ventricular septum. Some infants are born with a hole between the two atria, which normally closes within the first few weeks after birth. Ventricular septal defects are among the most common congenital heart defects and the most common cause for referrals to pediatric cardiologists.

    Affects of Ventricular Septal Defects

    • The ventricular septum is composed of numerous types of tissue. One section is composed of muscle and the other of narrow, stringy tissue. Most of the time VSDs close on their own, especially if they occur in the muscular section of the septum. Large VSDs can cause problems, particularly within the first few months of life. As pressure from the right side of the heart decreases, blood will begin to flow to the path of least resistance and will gradually lead to symptoms of congestive heart failure.

    Atrial Septal Defects

    • The right atrium of a healthy heart is separated from the left atrium by the atrial septum. Atrial septal defect is a hole in the atrial septum. When an ASD is present, blood flows through the gap from the left atrium to right atrium. This movement amplifies the blood volume in the right atrium causing more blood flow through the lungs than normal. Pulmonary hypertension, atrial arrythmias, increased risk of stroke and congestive heart failure can occur in adulthood if an ASD is left untreated in childhood.

    Affects of Atrial Septal Defects

    • As with VSD, ASD typically causes no symptoms. A very large ASD can allow so much blood flow that in can cause congestive heart failure symptoms like poor growth, fatigue and shortness of breath. ASD may close on its own without treatment, however, if the ASD is still present at age 3, most likely it will never close on its own.

    Tests and Treatments for Septal Defects

    • Septal defects are most often caught by a physician during a routine physical examination. If the physician hears a murmur in the heart, she may send the child to see a pediatric cardiologist. Electrocardiogram, chest X-rays and echocardiograms are all ways in which to check the severity of a septal defect. If ASD is still present at age 3, recommended treatments typically are open heart surgery and amplatzer septal occluder. VSD treatment commonly calls for observation and regular checkups with a pediatric cardiologist. If signs of congestive heart failure are present, medications such as diuretics and digoxin may be prescribed as well as medicine to help lower blood pressure.

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