Ventricular Septal Defect

Excerpt

Ventricular septal defects (VSDs) can be either congenital or acquired. The acquired form, referred to as ventricular septal rupture, occurs spontaneously and is associated with severe ischemic or inflammatory conditions. Congenital VSDs are the most common cardiac anomaly in children and are the second most common congenital abnormality in adults, following the bicuspid aortic valve.

The primary pathophysiological mechanism involves abnormal communication between the right and left ventricles and, in rare cases, between the left ventricle and right atrium, leading to shunt formation and subsequent hemodynamic compromise. While many cases experience spontaneous closure, persistent large defects can lead to detrimental complications, including pulmonary arterial hypertension (PAH), Eisenmenger syndrome, ventricular dysfunction, and an increased risk of arrhythmias. VSDs were first identified by Dalrymple in 1847.