Ventricular septal defect natural history, complications and prognosis

Associate Editors-In-Chief: Keri Shafer, M.D. [mailto:kshafer@bidmc.harvard.edu]; Atif Mohammad, M.D., Priyamvada Singh, MBBS

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

Other developments that can occur are -


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