Symptoms and course of ventricular septal defect

Symptoms and course of ventricular septal defect

1. The diameter of the ventricular septal defect, the amount of cardiac shunt, and the degree of pulmonary hypertension determine the severity of clinical manifestations. Small ventricular septal defects do not have any symptoms. Heart noise is mainly found during physical examination, and intraventricular defects are found after ultrasound examination. Some children may sweat and have a fast heart rate. Medium-sized ventricular septal defects usually include sweating, tachycardia, limited activity, and repeated respiratory tract infections. Children with large shunts at the tip of the heart have diastolic noise, P2. Incomplete closure of the aortic valve, and diastolic noise in the aortic area. Ventricular septal defects with large cardiac shunts often have clinical manifestations such as feeding difficulties, growth retardation, recurrent heart failure, and pneumonia. If elderly children suffer from severe pulmonary hypertension, they may have late symptoms such as shortness of breath and cyanosis after activity. Localized systolic tremor can be felt at the 3-4 intercostal space on the left side of the sternum and grade II-III or part of III children can touch.

2. Simple ventricular septal defects are more likely to heal on their own, especially in infancy. Follow-up data show that most small perimembranous atrial septal defects can close on their own by the age of 1, and some children can heal on their own in subsequent childhood and preschool years, but it is difficult to heal on their own after entering school age. The incidence of aortic valve prolapse and regurgitation increases with age.

3. It is generally believed that small ventricular septal defects do not affect the patient's cardiopulmonary function, health and life expectancy. Intermediate shunt ventricular septal defects, infant respiratory infections and heart failure, children's course of disease is relatively stable. If there is no surgical treatment, after entering adolescence, it will develop into organic pulmonary hypertension and eventually Eisenmenger syndrome. Endocarditis occurs on the basis of ventricular septal defects. Although the incidence is not high, it is also a problem worthy of attention. Children with Swiss cheese defects, due to large left-right shunts and severe pulmonary hypertension and heart failure, generally have difficulty surviving if pulmonary artery ring contraction is not performed as soon as possible.