Symptoms and Signs of Ventricular Septal Defect

Medical Author: John P. Cunha, DO, FACOEP
Medically Reviewed on 8/9/2021

Doctor's Notes on Ventricular Septal Defect

The two lower chambers of the heart are the ventricles, and the wall between them is called the septum. A hole in the septum is called a septal defect, also referred to as a “hole in the heart.” This abnormality usually develops before birth and is found most often in infants.  It causes oxygenated blood to mix with unoxygenated blood and results in the ventricles working harder than they should, which can lead to pulmonary hypertension or congestive heart failure

Small holes in the ventricular septum usually produce no symptoms but a child's doctor may notice a heart murmur. Large holes in the ventricular septum can cause symptoms including

  • rapid breathing,
  • sweating,
  • pale skin,
  • fast heartbeats,
  • decreased feeding, and
  • poor weight gain.

When a ventricular septal defect is not detected early on, it can cause more severe symptoms later in life including high pressure in the lungs (pulmonary hypertension), which causes fainting, shortness of breath, chest pain, resulting in a stroke, and can cause bluish discoloration of the skin (cyanosis).

What Is the Treatment for a Ventricular Septal Defect?

Ventricular septal defects range in severity from asymptomatic to severely debilitating. 

Smaller, asymptomatic ventricular septal defects usually do not need treatment but need to be monitored as they may become symptomatic or put patients at higher risk for a stroke

Medications used to treat ventricular septal defects include: 

  • Diuretics to help get rid of excess fluid
  • Digoxin to help the heartbeat slower and stronger

If a child is not developing adequately, a feeding tube may be needed for nutrition

Treatment for larger and more symptomatic ventricular septal defects includes: 

  • Intravascular procedures to place devices into the defect to close the hole
  • Open heart surgery for large or complicated defects


Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.