Ventricular Septal Defect: How Serious Is It?

Ventricular Septal Defect (VSD) is one of the most common types of congenital heart disease, accounting for about 20% of all congenital heart conditions. Children with small VSDs may not show any obvious symptoms, and approximately 25% of these cases have the potential to heal naturally. This spontaneous closure typically occurs in children under the age of five, particularly in those with membranous or muscular VSDs. Small to moderate-sized defects, usually less than 5mm in diameter, are more likely to close on their own. For these children, regular follow-ups with echocardiograms are strongly recommended to monitor the condition.

When VSD Healing Is Unlikely

However, certain types of VSDs, such as subarterial (also known as supracristal) and infracristal defects, have a much lower chance of spontaneous closure. In particular, subarterial VSDs can lead to aortic valve prolapse, which increases the risk of complications. For this reason, early surgical intervention is often advised for these types of defects rather than waiting for potential natural healing. Delaying treatment can result in progressive pulmonary hypertension, especially in cases of large VSDs, which may significantly reduce the chances of successful surgery or require long-term medication after the procedure.

Symptoms and Complications of Large VSDs

Common Signs in Affected Children

Children with larger VSDs often experience symptoms at a younger age. These may include frequent respiratory infections such as pneumonia, poor weight gain, and slow growth and development. These symptoms can place a significant emotional and financial strain on families, as repeated hospitalizations are often necessary. Additionally, untreated large VSDs increase the risk of developing serious complications like infective endocarditis, a dangerous infection of the heart lining.

Importance of Timely Treatment

Regardless of the size of the VSD, if the defect has not closed by the time the child reaches five years of age, surgical repair should be strongly considered. Waiting too long can lead to irreversible damage such as pulmonary hypertension or serious infections, which can complicate treatment and reduce long-term survival rates. Since each case is unique, it's essential for families to consult with a pediatric cardiologist or heart surgeon to determine the best course of action. Making medical decisions without professional guidance can lead to delays in treatment and worsen the prognosis.