Ventricular Septal Defect And Its Common Complications

Ventricular Septal Defect (VSD) is typically categorized into two types: restrictive and non-restrictive. Restrictive VSD usually refers to smaller defects where the left-to-right shunt is minimal. In such cases, the impact on a child's growth and development is generally limited, and symptoms may not be obvious aside from the presence of a heart murmur. However, even small VSDs can lead to a potentially life-threatening complication known as infective endocarditis.

Understanding Infective Endocarditis

Infective endocarditis involves an infection of the inner lining of the heart chambers and valves. If left untreated, it can lead to serious consequences such as embolism, which may cause strokes or damage to heart valves. Valve insufficiency, severe systemic infection, or even sepsis can develop, posing a significant risk to the patient's life. Prompt diagnosis and treatment are essential to prevent these dangerous outcomes.

Non-Restrictive VSD And Associated Risks

Non-restrictive VSD refers to larger defects where the volume of blood shunted from the left to the right ventricle is significantly increased. This can lead to early signs of congestive heart failure. Affected individuals may experience delayed growth, frequent respiratory infections, and breathing difficulties. The increased blood flow to the lungs results in pulmonary hypertension and dilation of the pulmonary arteries.

Effects Of Pulmonary Artery Enlargement

When the pulmonary artery enlarges, it may compress nearby structures such as the recurrent laryngeal nerve, leading to hoarseness or loss of voice. In addition, the expanded artery may press on the bronchus, especially the left main bronchus, causing bronchial narrowing. This can worsen lung infections and lead to chronic respiratory issues. If left unmanaged, the condition can progress to heart or respiratory failure, which can be fatal.

Long-Term Complications: Eisenmenger Syndrome

If pulmonary hypertension persists and progresses over time, it can result in a condition known as Eisenmenger syndrome. This syndrome is characterized by irreversible pulmonary hypertension and a reversal of the shunt, making surgical repair impossible. This type of VSD is often located near the aortic valve and can lead to aortic valve prolapse. Over time, this may cause aortic regurgitation, which can result in severe and potentially life-threatening complications.