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Newborn Health Series: ASD and VSD in Children

An atrial septal defect (ASD) is a hole between two sections of the heart. The heart is divided into four sections, called chambers. Children with an ASD have a hole between the two upper chambers called the atria. Having a large or medium size hole can change how our blood flows through the heart. It can make the heart work harder than it should, and this can cause health problems. A ventricular septal defect (VSD) is also a hole in the heart, but of the lower chambers called ventricles.

Both ASDs and VSD’s are common in children and are typically born with it. They may also occur together. Sometimes they cause heart murmurs, and doctors and nurses will listen for murmurs at your child’s regular checkups.


Symptoms of an ASD: Most babies and children with ASD’s have no symptoms. In these cases, the ASD is only found when the doctor or nurse hears a heart murmur at a routine checkup. If the ASD is large, your baby may have the following symptoms:

  • Losing interest in feeding

  • Fast breathing

  • Not growing well

  • Getting a lot of colds

  • Abnormal heartbeat

  • Tired easily

  • Skin that looks blue

Symptoms of a VSD: A baby or child with a small VSD might not have any symptoms. If the VSD is medium or large, it causes symptoms by the time the baby is 2 to 8 weeks old. These can include:

  • Heartbeat that seems faster than usual

  • Breathing that is fast, noisy, or both

  • Not gaining weight or growing

  • Acting hungry, but having difficulty feeding

  • Pale or blue skin

The doctor or nurse will be able to notice these symptoms at regular checkups, but if you are suspecting any of these symptoms, make sure to reach out to your pediatrician as soon as possible.


If your pediatrician suspects an ASD or VSD, he or she will most likely order a consult to a pediatric cardiologist and one or several of the following tests:

  • An electrocardiogram (ECG or EKG): this test measures the electrical activity in the heart.

  • A chest x-ray

  • An echocardiogram: this test uses sound waves to create a picture of the heart.


If these tests determine that your child has a small ASD or VSD, doctors may want to wait to see if it closes on its own before going to the next steps. It is common for small holes to close spontaneously without intervention. Your doctor will request regular checkups to closely monitor your child until the hole closes, or further intervention is needed.

There are some meds that may help close the ASD or VSD, and your pediatric cardiologist will determine if this route is appropriate before proceeding to surgery.

For ASDs, your pediatrician or pediatric cardiologist will try to wait until age 2 to surgically repair it. This is because there is still a small chance the hole will close on its own. If it is a VSD, the doctor will usually wait until age 6 months to 12 months to fix.

We found a great video explaining ASD vs VSD here.

As always- like, comment, and share!

Jeri Ford, RN, BSN, CPN

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