Ventricular septal defect natural history, complications and prognosis
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Ventricular septal defect Microchapters | |
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Differentiating Ventricular Septal Defect from other Diseases | |
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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
Overview
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
- Eisenmenger syndrome
- Atrial and ventricular arrhythmia can occur
Prognosis
Many small defects will close on their own. For those defects that do not spontaneously close, the outcome is good with surgical repair. Complications may result if a large defect is not treated.