What should I do if occasional chest tightness and shortness of breath occur due to a ventricular septal defect?

Written by Jia Qiu Ju
Cardiology
Updated on May 17, 2025
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Ventricular septal defect can cause chest tightness and shortness of breath. This indicates that the ventricular septal defect has already led to a decline in cardiac function, which may not have reached the severity of heart failure. However, factors such as increased physical activity, emotional changes, infections, etc., can increase the cardiac burden, leading to symptoms of heart failure, manifesting as chest tightness and shortness of breath. In severe cases, it can be accompanied by wheezing and episodes of respiratory difficulty. Therefore, if a patient is found to have a ventricular septal defect, this is a congenital heart disease that requires early surgical treatment. Currently, percutaneous transcatheter closure or thoracotomy for ventricular septal repair can be employed. The specific method of surgery depends on the detailed assessment of the ventricular septal defect.

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What are the symptoms of ventricular septal defect?

What are the symptoms of a ventricular septal defect? In normal individuals, there are no defects between the ventricular septa. However, if there is a small ventricular septal defect, such as less than five millimeters, typically ranging between two to three millimeters, this minor defect functions like small gaps between normal windows and doors, causing minimal shunting which generally does not significantly impact the patient, resulting in no obvious symptoms. However, if the defect is relatively large, such as exceeding five millimeters, causing significant left ventricular blood to shunt to the right ventricle, it can lead to congestion in the right ventricular system or pulmonary circulation. Under such conditions, patients may frequently experience respiratory infections, congestive heart failure, or in children, reluctance to eat, presenting feeding difficulties and developmental delays. Of course, if the defect continues to enlarge, achieving a size larger than the patient's aorta, the patient may show signs of significant right heart failure due to the damaged ventricular septum, necessitating emergency surgical intervention.

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Does a ventricular septal defect require open chest surgery?

Ventricular septal defects (VSD) can generally be treated through interventional procedures. Normally, defects with a diameter smaller than 3mm do not require surgical treatment. If the diameter is greater than 3mm but less than 10mm, interventional treatment is often feasible. Another scenario involves the subarterial type of defect, which generally cannot be repaired via a catheter-based approach and requires open-chest surgery instead. Additionally, for very large defects, repair must be conducted through open-chest surgery. Thus, for VSD, there are two main treatment options. Specific decisions require echocardiography to analyze the size and location of the septal defect to determine whether open chest surgery is necessary. Generally, most cases can be resolved through minimally invasive interventional methods.

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Does interventricular septal defect occasionally cause chest pain?

Ventricular septal defect is a type of congenital heart disease, occurring when the ventricles of the heart develop poorly during the embryonic stage, leading to a defect in the ventricular septum. This often results in a left-to-right shunt which affects the efficiency of the heart's function. In severe cases, it can cause a right-to-left shunt. Generally, these conditions do not affect the coronary circulation or cause chest pain in patients. However, some patients may develop endocarditis at the ventricular septum, which sometimes leads to the formation of vegetations on the cardiac valves or blood clots on the abdominal wall. If thrombosis or vegetations occur, there is a possibility of these breaking off. If they enter the coronary arteries, they can cause chest pain. However, such events are extremely rare, with an occurrence rate of less than one in a thousand.

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Is congenital heart disease with perimembranous ventricular septal defect serious?

Simple congenital heart defects, such as perimembranous defects, generally are not particularly severe. However, there are several scenarios to consider: The first scenario involves a large defect that typical occluders cannot address; in such cases, surgical intervention is required. This type of defect is generally considered severe. Another scenario is when a cardiac defect has been present for an extended period, leading to repeated shortness of breath, heart failure, cardiac enlargement, and even pulmonary arterial hypertension. This situation would be considered a severe ventricular septal defect, caused by the failure to treat the membranous part of the septal defect in time. Thus, the majority of ventricular septal defects are not very severe in the early stages. They become serious if the defect is too large or if there is coexistence with other defects, such as an overriding aorta or poorly developed pulmonary artery, among other complex congenital heart diseases. Regardless, patients with perimembranous congenital heart defects should undergo surgical treatment early to avoid missing the opportunity for surgery.

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Interventricular septal defect X-ray manifestation

X-ray Manifestations of Ventricular Septal Defect. These are mainly related to the size of the defect. If the ventricular septal defect is relatively small, for example less than three millimeters, the amount of blood shunted from the left ventricle to the right ventricular system is minimal. Consequently, right ventricular congestion is not pronounced, making pulmonary congestion also less obvious. At this point, the X-ray may show no significant changes. However, if the defect is larger, greater than three millimeters, for instance five millimeters, a large volume of high-pressure blood from the left ventricle will flow excessively through the defect into the right ventricular system. This leads to significant congestion in the right ventricle and, thus, in the entire pulmonary circulation. Additionally, the X-ray will show a prominent pulmonary artery segment and increased pulmonary blood flow. Moreover, over time, this condition may lead to compensatory enlargement of the left ventricular system. On the X-ray, enlargement of both the right and left ventricles can be observed. Furthermore, due to sustained high pressure, the distal pulmonary arteries may show signs of severe pulmonary vascular disease on the X-ray, resembling a broken book. This indicates that the pulmonary circulation has reached an end-stage condition.