1. Ventricular Septal Defect. Analysis of One Hundred Cases Studied During Life

¹ The Division of Pediatrics and the Division of Medicine, Hahnemann Medical College and Hospital and the Bailey Thoracic Clinic.

Certain data collected in the course of study of 100 consecutive patients with ventricular septal defect in whom right heart catheterization was performed have been presented.

Although the malformation has been thought to be of little significance our observations indicate that it is of serious import. The majority of victims have symptoms. Cardiac failure occurs relatively early in life in a large number. Roentgen and electrocardiographic abnormalities are the rule.

Pulmonary hypertension is present in a large number of patients. We believe that the large pulmonary flow results in functional contraction of the small pulmonary vessels. This results in increased resistance to flow and increased pulmonary pressure. Anatomic changes develop to further increase resistance. The direction of flow through the defect thus may change and a constant right to left shunt ensue. This is the natural history of those patients who are classified as having the Eisenmenger complex, a term which should be abandoned.

The symptoms and physical, roentgen and electrocardiographic signs of the defect are not characteristic. Diagnosis depends upon cardiac catheterization, supplemented in certain cases by contrast roentgen studies.