Ventricular septal defect natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Associate Editor-In-Chief: Keri Shafer, M.D. [2], Atif Mohammad, M.D., Priyamvada Singh, MBBS


Natural history of unoperated ventricular septal defect [1]-

Restrictive ventricular septal defect -

  • Small shunt (Qρ/Qѕ < 1.5/1.0 Qρ/Qs is pressure gradient between pulmonary and systemic circulation)
  • No significant hemodynamic compromise


Moderately restrictive ventricular septal defect

  • Moderate shunt (Qρ/Qѕ=1.5-2.5/1.0)
  • Hemodynamic burden on left atrium and ventricle.
  • Increase in pulmonary vascular resistance
  • Atrial and ventricular arrhythmia can occur


Large or Non restrictive venticular defect

  • High left and right ventricular volume overload
  • High pulmonary vascular resistance
  • Eisenmenger syndrome

Other developments that can occur are -

  • Spontaneous closure
  • Endocarditis
  • Aortic regurgitation
  • Subaortic or subpulmonary stenosis


References

  1. Braunwald Zipes Libby. Heart disease: A textbook of cardiovascular medicine, 6th Edition chapter 43 :W.B.Saunders;.pp 1595


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