A small ventricular septal defect may never cause any problems. Larger defects can cause a wide range of disabilities - from mild to life-threatening. Treatment can prevent many of these complications.
Ultimately, if a large ventricular septal defect goes untreated, increased blood flow to the lungs causes high blood pressure in the lung arteries (pulmonary hypertension). Over time, permanent damage to the lung arteries develops and the pulmonary hypertension can become irreversible. This complication, called Eisenmenger's syndrome, may occur in early childhood, or it can develop progressively over many years. In people with Eisenmengers' syndrome, the majority of the blood flow through the ventricular septal defect goes from the right ventricle to the left and bypasses the lungs. This means deoxygenated blood is pumped to the body and leads to a bluish discoloration of the lips, fingers and toes (cyanosis) and other complications. Once a child has Eisenmenger's syndrome, it is too late to surgically repair the hole because irreversible damage to the lung arteries has already occurred.
Other complications may include:
Heart failure. The increased blood flow through the heart due to a ventricular septal defect can also lead to heart failure, a chronic condition in which the heart cannot pump blood effectively.
Endocarditis. Children with a ventricular septal defect are at an increased risk of an infection of the heart (endocarditis).
Stroke. Children with large defects, especially occurring with Eisenmenger's syndrome, are at risk of a stroke due to a blood clot passing through the hole in the heart and going up to the brain.
Other heart problems. Ventricular septal defects can also lead to abnormal heart rhythms and valve problems.
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