Clinical Profile of Ventricular Septal Defect in Children in a Tertiary Care Hospital in Bangladesh

Abstract

Background: Ventricular septal defect (VSD) is the most prevalent congenital heart abnormality, comprising a quarter of all cases. When these VSDs are small and cause a left-to-right shunt, patients often remain asymptomatic, with the condition typically detected during routine physical examinations. On the other hand, larger VSDs can lead to a range of distressing symptoms in infants, including difficulty breathing, feeding challenges, inadequate growth, excessive sweating, and even early-onset cardiac failure. Objective: The objective of the study was to analysis the clinical profile and size and type of VSD in Paediatric patients admitted in a tertiary care hospital in Dhaka, Bangladesh. Methods: This prospective cross-sectional study spanned six months, commencing in January 2022 and concluding in June 2022. The research was conducted within the Department of Pediatric Cardiology at the Bangladesh Shishu Hospital and Institute. The study focused on children aged one month to eighteen who had received a clinical diagnosis of Ventricular Septal Defect (VSD). The confirmation of this diagnosis was achieved through echocardiography. Only cases where VSD was the sole cardiac abnormality were included in the study cohort. Data collection and subsequent analysis were conducted using SPSS version 24.0. Results: Among the total of 135 cases, 55.6% were male and 44.4% were female with male female ratio 1.25:1. 76.3 % cases presented in 1st year of life. Perimembranous VSD was the commonest (79.3%) followed by muscular (8/1%), Inlet (7.4%) and doubly committed VSD (5.2%). Common symptoms were cough (98.5%), fever (88.1%), breathlessness (85.1%), feeding problem (83.7%), failure to thrive (74.8%) and common sign were Pansystolic murmur (100%), tachypnea (98.5%), tachycardia (70/4%), crepitation (91.1%), subcostal retraction (98.5%), hepatomegaly (70.4%) and wheeze (7.4%) were the frequent clinical findings. Down syndrome associated with inlet VSD (2.9%). Complications associated with VSD were pneumonia (91.1%), malnutrition (74.8%), congestive cardiac failure (CCF) (70.4%), Eisenmenger syndrome (1.5%) and Infective endocarditis (1.5%). Conclusion: The perimembranous type is the most prevalent form of Ventricular Septal Defect (VSD). VSDs that are moderate to large can lead to severe symptoms and various complications. Timely identification and appropriate treatment are crucial in averting these associated complications, ultimately decreasing mortality and morbidity rates among affected children.