Ventricular Septal Defect: Common Symptoms and Their Connection to Defect Size

Ventricular Septal Defect (VSD) is a congenital heart condition that can present a wide range of symptoms, largely depending on the size of the defect in the heart's ventricular septum. Smaller VSDs often result in minimal or no noticeable symptoms, as the volume of blood flowing abnormally between the heart chambers—known as shunting—is limited.

Understanding the Impact of Defect Size

When the VSD is small, typically less than 5mm in diameter or less than half the width of the aortic valve, it is often classified as a restrictive defect. In such cases, individuals may live symptom-free and may not even be aware of the condition unless discovered during a routine medical examination.

Symptoms Associated with Larger VSDs

Conversely, larger VSDs—referred to as non-restrictive—can cause a variety of clinical symptoms. These defects allow a significant amount of blood to flow from the left ventricle to the right ventricle, increasing pulmonary blood flow and potentially leading to several complications. Infants and children with large VSDs may experience delayed growth and development due to the heart's inability to efficiently supply the body with oxygen-rich blood.

Respiratory Symptoms and Pulmonary Effects

Excess blood flow to the lungs can cause congestion in the pulmonary system, leading to rapid breathing, frequent respiratory infections, and difficulty feeding in infants. This congestion occurs because the left atrial pressure rises, hindering blood return from the lungs and causing fluid buildup.

Heart Function and Structural Changes

Over time, the heart may begin to enlarge as it works harder to compensate for the abnormal blood flow. This can lead to symptoms of heart failure, including fatigue, shortness of breath during physical activity, and swelling in the legs and abdomen. These signs indicate that the heart's function has been compromised due to the increased workload.

Diagnosis and Evaluation

Accurate assessment of VSD size and location is crucial for determining the appropriate treatment approach. Fortunately, modern non-invasive diagnostic tools such as echocardiography allow cardiologists to clearly visualize the defect and evaluate its impact on heart function. Early diagnosis plays a key role in managing symptoms and preventing long-term complications.