E ffect of Ventricular Septal Defect on the Growth Pattern of Children

Abstract

ABSTRACT:BACKGROUND:VSD is the most common cardiac malformation accounting for 25% of congenital heart disease. The VSDs are classified according to its haemodynamic effect into small, moderate and large. The VSD can affect the growth, which is defined as a progressive increase in size of the body as a whole or of its separate parts and can result in failure to thrive in affected patients.AIM OF THE STUDY:This study was done to demonstrate the effects of the VSD on weight, height and occiptofrontal circumference (OFC) of children as parameters of growth.METHODS:This is a prospective study of 50 patients with isolated VSD done in welfare Teaching hospital and Ibn Al-Bitar cardiac center during the period from January to July 2005. The diagnosis of VSD was done by clinical picture and confirmed by echocardiographic examination to study the effect of malnutrition and other factors on the growth another 50 patients without VSD were included as control group. For each patient the growth parameters (weight, height and head circumference) were measured.RESULTS:The age of the patients with VSD ranged from (14 days to 14 years). The male to female ratio was 1.1 to 1. In patients with VSD the weight of 20 patients (40%) were below 3rd centile in comparison with 3 patients in the control group and this is statistically significant (P<0.001), while the differences in the height of both groups was not statistically significant. The head circumference of 14 patients (28%) were below 2%, while, 3 patients (6%) only in control group and this difference was statistically significant (P<0.005). The effect of VSD on the growth parameters depended on the size of the VSD. There was a significant effect of moderate and large VSD on both weight and head circumference while small VSD had no such effect.CONCLUSION:From this study, we conclude that the weight is the most sensitive parameter for studying the effect of VSD on the growth parameters. The patients with moderate VSD, should be managed as serious as large VSD because of its adverse effect on growth.