Pregnancy and VSD

Women with repaired VSDs and normal heart function, or those with small, asymptomatic VSDs can have children without a higher than normal risk for problems during pregnancy. Women who have an unrepaired VSD or a closed VSD with heart and/or lung complications who desire to become pregnant should seek the advice of an adult congenital heart disease specialist and a specialist in high-risk pregnancy. With proper prenatal care and monitoring, these women usually can have successful pregnancies also.

Pregnancy is not recommended for women with large VSDs and pulmonary hypertension because of high maternal mortality rates.

When either the man or women has a congenital heart defect of any kind, their infant has a higher than normal risk of also having a congenital heart defect.

Eisenmenger Syndrome

About 10 percent of people with VSD develop Eisenmenger Syndrome, a complex array of problems caused by the difference in pressure between the left and right ventricles.

Early on, blood flows backwards through the large opening in the septum and into the right ventricle and floods the pulmonary arteries. Over time, changes occur in the thickness and elasticity of the pulmonary artery walls and high blood pressure (pulmonary hypertension) occurs in those vessels. As the blood vessels lose their elasticity, the heart pumps harder, causing it to weaken and results in right-sided heart failure. Flow then reverses across the VSD, resulting in low oxygen blood flowing into the systemic circulation. This can result in cyanosis (low blood oxygen, often seen as blue lips and extremities) and several other complications.

These individuals also may develop atrial fibrillation (a rhythm disturbance of the upper heart chambers), aneurysms in the pulmonary arteries and other complications. The average life expectancy of people with Eisenmenger Syndrome is less than 40 years. Newer medical therapies and close medical attention may significantly improve outcomes in these patients.

Last reviewed by a Cleveland Clinic medical professional on 07/18/2019.

References

References

  • Darst JR, Collins KK, Miyamoto SDCardiovascular Diseases. In: Hay WW, Jr., Levin MJ, Deterding RR, Abzug MJ. eds. CURRENT Diagnosis & Treatment: Pediatrics, 22e. New York, NY: McGraw-Hill; 2013.
  • American Heart Association. About Congenital Heart Defects Accessed 3/12/2015.
  • Centers for Disease Control and Prevention. Facts about Congenital Heart Defects Accessed 3/12/2015.
  • National Heart, Lung, and Blood Institute. What are Congenital Heart Defects? Accessed 3/12/2015.
  • Hirsh JC, Devaney EJ, Ohye RG, Bove EL. Chapter 19B. The Heart: II. Congenital Heart Disease. In: Doherty GM. eds. CURRENT Diagnosis & Treatment: Surgery, 13e. New York, NY: McGraw-Hill; 2010.

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