PROGNOSIS OF ISOLATED VENTRICULAR SEPTAL DEFECTS

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Abstract
Patients (72) with isolated ventricular septal defects are classified into 3 groups on the basis of right ventricular systolic pressure. The first group with normal pressures (27 cases) showed: a high pitched systolic murmur over the 3d to 4th left interspaces poorly transmitted; a normally split second sound; and a normal ecg in 20 cases. The second group with pressures varying from 30-65 mm Hg and left-to-right shunt (17 cases) had: a heaving cardiac impulse frequently; a harsh systolic murmur; a highly-accentuated with a very short interval between aortic and pulmonary components; a faint mid-diastolic apical murmur in some cases; an abnormal ecg in 11 cases, predominantly left (3 cases) and combined right and left (7 cases) ventricular hypertrophy. The third group, consisting of patients with equilibrated pressures ranging from 55 to 125 mm Hg (28 cases), had essentially the same findings as those in the Group II although in a few cases of those with mixed shunts there were no murmurs at all. The findings of Group III are characteristic of rather severe hemodynamic changes. It seems likely that the prognosis in patients belonging to Group III is poor and that it is rather good in Group I.