Ventricular Septal Defect And Its Common Complications

Ventricular Septal Defect (VSD) is a congenital heart condition characterized by an abnormal opening in the wall separating the two lower chambers of the heart. When the defect is relatively large, typically exceeding 3mm, patients may experience a range of complications that can significantly affect their health and development.

Chronic Heart Failure

One of the most common complications of a large VSD is chronic heart failure. This occurs due to the increased workload on the heart caused by abnormal blood flow. Symptoms in children may include rapid breathing, increased heart rate, and poor growth. Without timely intervention, the heart may struggle to pump blood efficiently, leading to long-term complications.

Recurrent Respiratory Infections

Children with VSD are more susceptible to frequent respiratory infections, including pneumonia and bronchitis. The excessive blood flow to the lungs weakens the respiratory system, making it easier for infections to develop and harder for the body to fight them off.

Pulmonary Hypertension

Pulmonary hypertension is a serious and common complication associated with large VSDs. If the defect is significant and the child is over two years old, the pressure in the pulmonary arteries may continue to rise. In advanced stages, this can lead to irreversible pulmonary hypertension. Once this condition reaches an irreversible state, surgical correction may not alleviate the symptoms, and the child may have permanently elevated lung pressures, reducing their quality of life.

Infective Endocarditis

Another major concern is the risk of infective endocarditis. The abnormal blood flow from left to right across the heart can cause damage to the heart lining and valves, particularly the mitral and tricuspid valves. This damage creates a surface where blood clots and bacterial growth can develop, potentially leading to heart failure. If a clot dislodges, it can travel to the brain and cause a stroke or even cerebral palsy, resulting in neurological symptoms such as numbness, paralysis, or coma.

Valvular Complications

Aortic Valve Regurgitation

When the VSD is located near the top of the heart, especially beneath the pulmonary valve, it can lead to complications involving nearby heart valves. This anatomical position may cause aortic valve prolapse and regurgitation. As the condition progresses, especially in older patients, surgical replacement of the aortic valve might be necessary. However, valve replacement surgery is costly and complex, and the long-term implications can significantly affect a patient's lifestyle and overall well-being.