Calixtro, Laidelle Jascinth M.

BSN-III

NARRATIVE PATHOPHYSIOLOGY OF VENTRICULAR SEPTAL DEFECT

A ventricular septal defect (VSD) is a Congenital heart defect in which there is a hole in
the wall separating the two lower chambers of the heart. In normal development, the wall between
the chambers closes before the fetus is born, so that by birth, oxygen-rich blood is kept from
mixing with the oxygen-poor blood. When the hole does not close, it may cause higher pressure
in the heart or reduced oxygen to the body. A ventricular septal defect happens during pregnancy
if the wall that forms between the two ventricles does not fully develop, leaving a hole. A
ventricular septal defect is one type of congenital heart defect (CDC, 2018).

Ventrical Septal Defect is idiopathic. Several patients have heart defects due to variations
in their genes or chromosomes. Heart defects are often believed to be caused by a mixture of
genes and other etiological factors, for instance, some objects that might have in contact with the
mother or the food, drinks, or drugs that the mother intakes. The Ventricular Septal Defects can
be classified into four different categories such as the Perimembranous Ventricular Septal Defect,
in which there is a hole in the upper section of the ventricular septum; Inlet Ventricular Septal
Defect, in which this is a hole in the septum near to where the blood enters the ventricles through
the tricuspid and mitral valves. This type of ventricular septal defect also might be part of another
heart defect called an atrioventricular septal defect; Conoventricular Ventricular Septal Defect, in
which there is a hole where portions of the ventricular septum should meet just below the
pulmonary and aortic valves; Muscular Ventricular Septal Defect where there is a hole in the
lower, muscular part of the ventricular septum and is the most common type of ventricular septal
defect.

Its pathophysiology begins as systemic-to-pulmonary circulation connection exist.

Increased pulmonary blood flow occurs resulting in endothelial dysfunction and vascular
remodeling, smooth proliferation of muscle cells, increased extracellular matrix, and intravascular
thrombosis. There is an improvement in pulmonary vascular resistance. Inversion of shunt
happens, shunt is now right-to-left, resulting in the patient suffering cyanosis, anemia, dyspnea,
weight loss. Its progression could lead to severe complications such as arrhythmias, heart valve
problems, lung problems, heart failure, poor growth and development.
 The prognosis is good, early management can dramatically decrease chance of
complications in the future. Small VSD usually closes in 2 years, if not problems may occur,
prompting medical interventions to close down the opening in the ventricular septum, in order to
secure the health of a person, failure to secure medical management makes them prone to VSD
complications. The prognosis is good, early intervention will significantly reduce the risk of
complications in the future. Small VSD normally closes within 2 years, if there are no issues,
causing medical procedures to close the opening in the ventricular septum in order to ensure a
person's wellbeing. Failure to secure medical management makes them vulnerable to VSD
complications.

REFERENCES:

Congenital Heart Defects - Facts about Ventricular Septal Defect. (2019, November 12).
Retrieved November 03, 2020, from
https://www.cdc.gov/ncbddd/heartdefects/ventricularseptaldefect.html

Ventricular Septal Defect (VSD). www.heart.org. (2020). Retrieved 4 November 2020,

from https://www.heart.org/en/health-topics/congenital-heart-defects/about-congenital-heart-
defects/ventricular-septal-defect-vsd.