Clinical Manifestations of Ventricular Septal Defect in Young Children

General Symptoms

One of the most noticeable signs in children with VSD is developmental delay. Infants and toddlers may grow at a slower rate compared to their peers, with both weight and height falling below standard growth curves. This failure to thrive is often due to increased metabolic demands and poor feeding efficiency.

Feeding Difficulties

Many children with VSD experience challenges during feeding. They may show signs of poor appetite, consume smaller amounts of food, and tire easily during meals. Excessive sweating, especially during feeding or minimal physical activity, is also commonly observed.

Recurrent Respiratory Infections

Since VSD typically causes increased pulmonary blood flow, children are more prone to respiratory infections. These may include frequent bouts of colds, coughing, fever, and nasal congestion. During seasonal changes, symptoms can worsen, sometimes leading to more serious conditions like pneumonia or bronchitis. Shortness of breath, especially during physical exertion, is another common symptom.

Signs of Hypoxia

In more severe cases where pulmonary hypertension develops, children may experience right-to-left shunting of blood, leading to hypoxemia. This can cause cyanosis—bluish discoloration of the lips and skin—especially during crying spells. Pallor, clubbing of the fingers, and a visible bulge in the chest area may also be present.

Physical Examination Findings

A key diagnostic clue is the presence of a loud, harsh systolic murmur best heard along the lower left sternal border, typically between the third and fourth ribs. This murmur is often detected during routine pediatric checkups. If a child presents with the above symptoms and a heart murmur, further investigation with an echocardiogram is strongly recommended to confirm the diagnosis.