What're the signs and symptoms of ventricular septal defect?The most common signs and symptoms are trouble eating and gaining weight, breathlessness and easy fatigability. A baby with a large VSD tires quickly after not eating very much, falls asleep, wakes us in a short while quite hungry, tries to eat again, tires easily, and the cycle is repeated.
Ventricular septal defects have a very characteristic murmur, to the point where a cardiologist may be able to pinpoint the location and estimate the size of a ventricular septal defect just by how it sounds. However, a murmur is often not heard at birth, especially in a large ventricular septal defect. It is only when there is excessive flow across the hole into the lungs that a murmur can be appreciated.
A smaller hole may actually make a louder noise than a large hole, and the murmur may get louder as the ventricular septal defect closes. Think of a garden hose. If the water flows freely, it makes a soft sound. If you narrow the outlet of the hose with your finger; however, the noise will get louder. It's important to remember a loud murmur does not necessarily mean a large hole.
Babies who do have moderate or large ventricular septal defects with excessive blood flow to the lungs will have signs of congestive heart failure. The most important sign will be the baby's growth. Babies who have significant congestive heart failure will have failure to thrive and will have difficulty maintaining a normal weight gain in the first few months of life. Babies with some extra flow to the lungs may grow well because their ability to feed remains unaffected. They may have some subtle signs of congestive heart failure such as continuous fast breathing.
If a baby grows well in the first few months, it is likely that the ventricular septal defect will not lead to congestive heart failure and the baby can be observed. If the baby does show significant signs of congestive heart failure, the ventricular septal defect may need to be surgically closed.
In older children, a ventricular septal defect may be evident by causing easier tiring with exercise or lower energy levels compared to other children the same age.