Ventricular septal defect natural history, complications and prognosis

Ventricular septal defect Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Keri Shafer, M.D. [2]; Atif Mohammad, M.D., Priyamvada Singh, MBBS

Natural History

Natural history of unoperated ventricular septal defect

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

Complications

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

References

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