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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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.

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Can a ventricular septal defect heal by itself?

Some ventricular septal defects can heal on their own. For ventricular septal defects smaller than five millimeters, some patients can heal on their own; the defects that generally heal are those in the membranous and muscular parts of the septum, and the younger the age, the greater the likelihood of healing. If the ventricular septal defect still exists after the age of five, it generally cannot heal on its own. For ventricular septal defects that do not heal spontaneously, if they significantly affect hemodynamics, interventional treatment or surgical surgery is needed for repair. If the impact of the ventricular septal defect on hemodynamics is not significant, regular follow-up examinations can be conducted to understand the condition of the disease.

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Is ventricular septal defect related to premature birth?

Generally, premature birth is not related to ventricular septal defect. Although a premature infant is born early, their heart structure, lungs, and other body structures are normal. Ventricular septal defect is often caused by a developmental disorder of the septum during the fetal period, manifesting as left-to-right or right-to-left shunting. Generally, patients with a simple ventricular septal defect can survive normally. They can be completely cured through interventional treatment or surgical surgery, so there is no need to worry excessively. There is no direct connection between ventricular septal defect and premature birth.

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What should I do about hypoxia due to a ventricular septal defect?

Mild ventricular septal defects generally do not cause hypoxia. If symptoms of hypoxia recur due to a ventricular septal defect, it is recommended to undergo minimally invasive interventional treatment or surgical treatment at a hospital to prevent further episodes. The success rate of this surgery is very high, almost 100%, with relatively few complications. If hypoxia occurs in untreated ventricular septal defects, initial therapy should include oxygen administration, followed by diuretic, cardiotonic, and other treatments to reduce cardiac load at a hospital, and surgery should be considered as soon as suitable.

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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.