Delayed Diagnosis of Ventricular Septal Defect (VSD)

Background: Although ventricular septal defect (VSD) is the most common congenital heart disease, it is usually diagnosed late. The image of the disease is variable; sometimes it is so quit and silent that might even be healed and be improved spontaneously, and in some certain cases if the appropriate, on time and early treatment is not be done, this would lead to irreparable complications even in the early life period such as mortality. This study aimed to study, review and the way of diagnosis process, treatment and follow-up of these patients. It is hoped that the results of the present study be used in order for improving the patient’s condition.

Methods: This was a cross-sectional study done on 145 patients with VSD during 54 months in Isfahan. The required data collected at the time of definite diagnosis by taking their history. The disease was identified through Color Doppler echocardiogram, and cardiac catheterization and angiography if necessary.

Results: The average age of the initial diagnosis of the disease was at 17 months old and average age of the definite diagnosis was at 44 months old. The initial diagnosis in 85% of the cases was associated with heart murmur. In 27.5% of the cases, VSD had been associated with other cardiac anomalies. Pulmonary artery hypertension was observed in 16.5% of the cases. Fifty nine surgeries were performed on 40 patients.

Conclusion: In routine and daily examination of the infants, the probability of heart disease should be considered; conducting echocardiogram and cardiac consultation in the suspected cases would lead to early diagnosis and eventually the timely treatment. Appropriate follow-up of the patients will cause providing the optimal care and treatment services at the r...

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...s and ultimately treatment of the heart disease.

3. Considering the possibility of additional cardiac anomalies and also pulmonary artery hypertension would provide optimal care and treatment services at the right time.

References

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Table1: The type of VSD and additional cardiac anomalies, pulmonary artery hypertension (PAH), the number and age of the surgery in the studied patients.

type of VSD Number (percent) PAH No. (%) Surgery No. (%) Age of surgery (month)

Single VSD 105 (72.5) 8 (7.6) 15 (14) 45 ± 22

VSD with additional cardiac anomalies 40 (27.5) 16 (40) 19 (47.5) 37 ± 14

Patent ductus arteriosus 20 (50) 11 (55) 19 (95) 10 ± 3

Patent ductus arteriosus with aortic coarctation 6 (15) 5 (83) 5 (83) 10 ± 3

Atrial perforation 5 (12.5) - 1 (20) 44 ± 29

Pulmonary artery stenosis 9 (22.5) - -

Bacterial endocarditis 1 (0.7)

Mortality 2 (1.4)