What is it?

-A ventricular septal defect (VSD) is a hole in the ventricular septum, the wall dividing the left and right ventricles of the heart. VSD's are usually congenital (present at birth) and they vary in size. They may be an isolated finding or associated with other conditions.
-An atrial septal defect (ASD) is a hole in the wall (septum) that separates the two atria of the heart. In the fetus, there are openings in this wall that close before birth. Atrial septal defect is a condition in which these openings have not closed properly and a hole remains. As a result, blood continues to flow between the two sides of the heart. In some cases, the atrial septal defect is small, asymptomatic and may even close on its own. In other cases, and especially if there is a significant shunt, the abnormal flow may put a significant strain on the heart over time, and cause the development of heart or lung disease. Therefore, it is important to diagnose and fix the atrial septal defect at a young age and thus prevent future problems.
-Tetralogy of fallot (TOF) is a rare condition, characterized by a combination of four heart congenital defects. These defects result in poor oxygenated blood to travel to the body, and that’s why the skin may appear bluish. Depending on its severity, tetralogy of fallot may be detected soon after birth, or even in adulthood. The four abnormalities include: pulmonary valve stenosis, VSD, overriding aorta and right ventricular hypertrophy. This condition may be accompanied by other heart defects. Risk factors include maternal virus illness, such as rubella, alcoholism and poor nutrition in pregnancy, older maternal age, a parent with TOF, or a child who has Down syndrome or DiGeorge syndrome.

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Additional names

This group contains additional names:
- Tetralogy of Fallot
- Endocardial cushion defect
- Common arterial trunk (truncus arteriosus)
- Common Truncus
- Common arterial trunk
- Tetralogy of Fallot

Signs & symptoms

-The clinical presentation of a VSD varies depending upon the size of the defect, and may range from an isolated murmur that is detected incidentally at a health supervision visit to severe heart failure. Infants with small, restrictive VSDs usually do not present any symptoms. In contrast, infants with moderate to large VSDs usually manifest signs of heart failure by three to four weeks of age. common symptoms include:
* Poor feeding (may appear hungry but tires easily; sweats with feeds)
* Poor weight gain
* Difficulty breathing or rapid breathing
* Pale skin coloration

-In most cases, atrial septal defect at childhood is an asymptomatic condition that is usually discovered by chance (by detecting a cardiac murmur). In adulthood, around the age of 30-40, signs of heart or lung disease may appear. Possible symptoms are shortness of breath, edema in the legs or ankles, rapid or irregular heartbeat and intolerance to physical exertion.

-Tetralogy of fallot symptoms may include bluish skin, shortness of breath, fainting, clubbing in the fingers and toes, poor weight gain, easy tiring, irritability, prolonged crying and a heart murmur.


Diagnosis of these congenital heart defects begin with a physical examination by a doctor. The suspicion is confirmed using an echocardiogram, a test that demonstrates the structure of the heart and the blood flow in it. Other tests that may be needed are a chest x-ray and an ECG (a test that measures the electrical activity of the heart).


-If the VSD is small and not causing any symptoms, your doctor may recommend a wait-and-watch approach to see if the defect corrects itself.
In more severe cases, surgery is required to repair the damage. Surgery may be an open surgery, or it may be done through a catheter inserted into a blood vessel up to the heart.

-Small and asymptomatic atrial septal defect may close on its own and does not necessarily require treatment. atrial septal defect that remains open beyond the age of two or three years needs to be repaired as there is a concern that it will cause symptoms at an older age. Closing the atrial septal defect is done by catheterization (using a tube that is inserted into a blood vessel up to the heart) or by open heart surgery.

-Surgery is the only effective treatment of TOF. Intracardiac repair is an open heart surgery done in the first year of life. Sometimes, babies need a palliative surgery before having intracardiac repair in order to improve blood flow to the lungs.

☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.

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