Ventricular Septal Defect (VSD) in Babies
Content reviewed against published CDC, AAP guidelines
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If your baby has been diagnosed with or you suspect ventricular septal defect (vsd) in babies, here is what the evidence says.
The short answer
A ventricular septal defect (VSD) is a hole in the wall between the heart's lower chambers and is the most common congenital heart defect, occurring in about 1 in 240 to 500 babies. Small VSDs often cause no symptoms and close on their own within the first few years of life. Larger VSDs may cause heart failure symptoms and require surgical repair. With appropriate management, the long-term outlook is excellent.
Key takeaways
- A ventricular septal defect (VSD) is a hole in the wall between the heart's lower chambers and is the most common congenital heart defect, occurring in about 1 in 240 to 500 babies. Small VSDs often cause no symptoms and close on their own within the first few years of life. Larger VSDs may cause heart failure symptoms and require surgical repair. With appropriate management, the long-term outlook is excellent.
- Usually normal when: Your baby has a small VSD detected by murmur, but is feeding well, gaining weight normally, and has no symptoms
- Call your doctor if: Your baby is breathing very rapidly (more than 60 breaths per minute at rest), refusing to eat, or appears gray or blue
- Varies by age — see the age-by-age breakdown below
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By Age
What to expect by age
0-3 months
A VSD is usually detected by a heart murmur heard during a newborn exam or early well-child visit. Paradoxically, the murmur of a small VSD is often louder than a large one. Small VSDs typically cause no symptoms. Larger VSDs may not cause symptoms right away because pulmonary pressure is still high in the first weeks of life, but as pressure drops, excess blood flow to the lungs increases and symptoms begin to appear — rapid breathing, difficulty feeding, and poor weight gain.
3-6 months
This is when moderate to large VSDs often become symptomatic. Babies may breathe rapidly (especially during feeding), sweat on the forehead while eating, tire before finishing feedings, and gain weight slowly. Medications such as diuretics may be used to manage symptoms. If the VSD is large and the baby is struggling despite medication, surgical repair is typically planned during this period.
6-12 months
Small VSDs continue to be monitored and many show signs of getting smaller. Babies with large VSDs that have been surgically repaired typically show dramatic improvement in feeding and growth after surgery. The murmur may change or get quieter as a small VSD shrinks. Regular echocardiograms track the size of the defect.
12 months+
Many small VSDs close completely by age 2-5, though some persist as tiny, hemodynamically insignificant holes. Children with closed or small VSDs typically have no restrictions or long-term effects. Children who had surgical repair usually lead completely normal lives with periodic cardiac check-ups. The repair is considered a long-term success in the vast majority of cases.
What Should You Do?
When to take action
- Your baby has a small VSD detected by murmur, but is feeding well, gaining weight normally, and has no symptoms
- Your baby's VSD is getting smaller on follow-up echocardiograms
- Your baby had VSD repair and is growing and developing well
- Your pediatrician describes the murmur as loud but the echocardiogram shows only a tiny hole
- Your baby has a heart murmur that has not been evaluated with an echocardiogram
- Your baby with a known VSD is starting to breathe faster, sweat during feedings, or gain weight slowly
- Your baby's murmur has changed in character or you have noticed new symptoms
- Your baby is breathing very rapidly (more than 60 breaths per minute at rest), refusing to eat, or appears gray or blue
- Your baby who had VSD surgery develops fever, wound redness, or drainage from the surgical site
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss Ventricular Septal Defect (VSD) in Babies.
Things to mention
- Your baby has a heart murmur that has not been evaluated with an echocardiogram
- Your baby with a known VSD is starting to breathe faster, sweat during feedings, or gain weight slowly
- Your baby's murmur has changed in character or you have noticed new symptoms
Observations to share
- Your baby has a heart murmur that has not been evaluated with an echocardiogram
- Your baby with a known VSD is starting to breathe faster, sweat during feedings, or gain weight slowly
- Your baby's murmur has changed in character or you have noticed new symptoms
Urgent signs to report immediately
- Your baby is breathing very rapidly (more than 60 breaths per minute at rest), refusing to eat, or appears gray or blue
- Your baby who had VSD surgery develops fever, wound redness, or drainage from the surgical site
My notes
From ismybabyalright.com — free, evidence-based baby health guides
Related Resources
Frequently asked questions
Is ventricular septal defect (vsd) in babies normal?
When should I call the doctor about ventricular septal defect (vsd) in babies?
When is ventricular septal defect (vsd) in babies normal?
What causes ventricular septal defect (vsd) in babies?
What should I mention to my pediatrician about ventricular septal defect (vsd) in babies?
Is ventricular septal defect (vsd) in babies normal at 0-3 months?
Is ventricular septal defect (vsd) in babies normal at 3-6 months?
Should I go to the ER for ventricular septal defect (vsd) in babies?
Does ventricular septal defect (vsd) in babies go away on its own?
References
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources
Related Resources
Bottom line
Most cases of ventricular septal defect (vsd) in babies are normal. Talk to your pediatrician if your baby is breathing very rapidly (more than 60 breaths per minute at rest), refusing to eat, or appears gray or blue.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.
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