Epidemiological Profile, Diagnostic Approach and Associated Complications of Ventricular Septal Defect in a Pediatric Population

Ventricular septal defect (VSD) is the most common congenital heart defect in children, associated with important considerations for disease epidemiology, diagnosis, and long-term outcomes. VSD results from a deficiency in growth or the failure of alignment or fusion of the components of the ventricular septum. This study aimed to describe the epidemiological profile, diagnostic approach, and associated complications of VSD in a pediatric population. This cross-sectional study was conducted in the Department of Pediatric Cardiology, Combined Military Hospital, Dhaka, Bangladesh, from January 2018 to December 2018. This study included 46 pediatric patients less than 12 years old with isolated VSD. The mean age of the participants was 2.78 ± 3.44 years, with a slight male predominance (male-to-female ratio of 1.09:1). Most patients (60.87%) were under one year of age. A family history of congenital heart disease was reported in 13.04% of cases. Common presenting symptoms included feeding difficulty (69.57%), cough (60.87%), poor weight gain (54.35%), and head sweating (50%). Respiratory distress was the most frequently observed clinical sign (71.74%), followed by tachycardia (47.83%) and failure to thrive (41.30%). Echocardiography was the definitive diagnostic tool, performed in all cases. Other investigations included ECG (82.61%), chest X-ray (76.09%), and cardiac catheterization (8.70%). Perimembranous VSD was the most prevalent type (67.39%), and the majority of defects were small in size (58.70%). Pulmonary hypertension was the most common complication, noted in 58.70% of patients, followed by aortic cusp prolapse (23.91%) and aortic regurgitation (17.39%). Ventricular septal defect remains a significant pediatric cardiac condition, predominantly affecting infants. Early diagnosis, with the help of a clinical picture and widely and easily accessible diagnostic tools like echocardiography (ECHO), will help initiate timely treatment and decrease mortality. Pulmonary hypertension was the most frequent complication, followed by aortic cusp prolapse and aortic regurgitation.