What are the symptoms of ventricular septal defect (VSD)?
In VSD, since more blood goes into the lungs, lungs have to work more and thus child may have breathlessness. Since more blood comes into left atrium and then left ventricle, the left atrium and ventricle enlarge. Also since right ventricle also receives more blood, right ventricle also enlarges. The child will have an enlarged heart which may not work well. On exertion, breathlessness increases. The body tries to compensate by increasing the pressure in the pulmonary artery (pulmonary hypertension) to decrease the amount of blood entering into the lungs. If the pulmonary pressures become too high, then the blood would flow from right side of the heart to the left with mixing of oxygen poor blood with oxygen rich blood and causing bluish discoloration of the skin. This is known as Eisenmenger’s complex.

Do all children with VSD develop Eisenmenger’s complex?
No, all children with VSD do not develop Eisenmenger’s complex. It is only those in whom pulmonary pressures are high which is commonly seen with large holes.