Re: Ventricular Septal Defect

Posted By Miriam  on August 26, 1998 at 12:01:46:

In Reply to: Re: Ventricular Septal Defect posted by CCF CARDIO MD - MTR on August 21, 1998 at 14:18:03:






Hello, I've gotten involved with this forum due to my father's heart problems  and it has been very helpful.  His problems, though unrelated, have led me to start being more concerned about my own heart problem.
I was born with a small hole between the ventricles of the heart.  When I was young every doctor could hear the murmur; it was quite loud.  In 1990 when I was about 37 I went to a cardiologist for an evaluation just to make sure everything was OK because I was having a lot of palpitations.  He did an echocardiogram and said I only had the ventricular problem, no hole between the atria, and that the palpitations didn't seem to be caused by any organic cause.
About 2 years ago at age 42 I went to a different cardiologist to be evaluated because again I was having palpitations (I've since decided they are stress-related).  He was unable to hear the murmur and concluded the hole must have closed up.  He did not do an echocardiogram but did look at the previous one that had been done.
From what I have read, it is unusual for a VSD to close up of its own accord after puberty.  Is it possible it closed up since my previous examination in 1990?  Is there any other reason the murmur could have gone away?  If the VSD  is actually still there, is there any long-term risk to my heart?  Should I ever consider having it repaired?  Should I have another echocardiogram to make sure it really is closed?
I don't have any symptoms that I am aware of but I do get out of breath easily with exertion, a problem I've attributed to being about 30 lbs. overweight and not in particularly good shape.  I am also very tired in the morning but I've never been a morning person anyway so who knows if that means anything.  (I know, I need to lose weight and exercise).
Any information on VSD's and my condition would be appreciated.  Thank you!
-Miriam









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Dear Miriam, thank you for your question.  If you did indeed have a VSD (ventricular septal defect) that has closed on its own in your adult life, that would be unusual.  Most commonly, VSDs noticed in childhood are surgically repaired unless they are very small and don't seem to be causing any serious problems.  Thus, you may have had a very small VSD as a child, which could have caused a loud murmur (the murmur intensity does not correlate with the size of the VSD).  While a physical exam should be good to exclude a murmur, only an echocardiogram can determine for sure whether your VSD has closed.  The disappearance of your murmur can only be explained as a closing of the VSD (if that truly caused your original murmur).  If you still have a small VSD, I can't determine in this forum whether it would need to be surgically corrected.  That decision would depend on your heart function and internal heart pressures and only your cardiologist can determine whether that would be necessary.  Your symptoms may be related to deconditioning from inactivity but I would need to view your echocardiogram to truly determine that.  Thus, I think it would be good for you to be reevaluated by your cardiologist to clear up the uncertainty that exists regarding the VSD.  I hope the information provided has helped.  Information in the heart forum is for general purposes only.  Your physician can only provide specific diagnoses and therapies.












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Thank you for your reply.  They didn't operate on my VSD as a baby or young child because I believe they considered the hole small enough not to cause problems.  I've been able to participate in physical activities all my life with no ill effects that I can tell.  When I was younger and thinner I never had any problems keeping up with everything.  However, I did have a sister born 2-1/2 years later who had a much more severe ventricular hole and only survived 4 months.  Back then they did not have the microscopic surgery necessary to operate on small babies and they were hoping she would grow enough to be able to operate on her but she never did.
I will take your advice and see a cardiologist again in the next few months (once my dad's problems are out of the way) and have another echocardiogram.  If by any chance they decide the problem needs to be corrected at that time, what is the surgical procedure?  Are we talking open-heart surgery or something done via angioplasty type methods?  Please let me know, this is worrying to think about!  Thanks for your help.
-Miriam