A ventricular septal defect (VSD) is a type of congenital heart disease in which there is a hole in the wall (septum) of the heart between the right ventricle and the left ventricle.
Because there is extra blood going into the lungs, the arteries in the lungs may tighten to control the blood flow. This can eventually cause the pressures in the lungs to rise, called pulmonary hypertension. The high pressure in the lungs causes extra work for the right ventricle. If the pressure in the lungs becomes too high, the pressure needed for the right ventricle to squeeze blood to the lungs may be higher than the pressure needed for the left ventricle to squeeze blood to the body. This causes the blood flow through the VSD to “reverse”. The blue blood now goes from the right ventricle into the left ventricle. This can make the patient “blue”, also known as cyanosis. The “reversal” of blood flow between the ventricles is called Eisenmenger syndrome.
A small VSD may cause no heart problems. There is a small risk of an infection of the hole, called endocarditis. Once a VSD is fixed, the left side of the heart will often return to normal size and symptoms will get better. If the pressures in the lungs were high, they may return to normal. Sometimes the left heart doesn’t return to normal or the lung pressures remain high. Those patients need regular lifelong care from a cardiologist specializing in congenital heart defects. Patients with Eisenmenger syndrome need lifelong specialized care.
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