| Clinical Evaluation of 185 cases of Ventricular Septal Defect. |
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Sung Kyu Lee, Pil Rai Chung, Jun Hee Sul, Dong Sick Chin, Duk Jin Yun |
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Department of Pediatrics, Yonsei University, College of Medicine, Seuol, Korea. |
| 소아 심실중격 결손증의 임상적 관찰 |
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이승규, 정필래, 설준희, 진동식, 윤덕진 |
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연세대학교 의과대학 소아과학교실 |
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| Abstract |
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One hundred and eighty nine cases of ventricular septal defect, which was confirmed by cardiac catheterization at Severance Hospital, were observed on clinical, hemodynamic, electrocardiogr sphic findings and their correlation, during the period from January, 1964 to December, 1979. The six hundred and forty one cases of congenital heart disease under fiften years old received cardiac catheterization during this period. The incidence of ventricular septal defect was 35.1% in our hospital. Sixty nine cases had corrective surgery at the Department of Chest Surgery, Yonsei University. The results were as follows; 1) One hundred and eight nine cases of ventricular septal defect included. One hundred and ten male patients and Seventy five. Female patients. 2) The age distribution of the one hundred and eight five cases of ventricular septal defect were 59 cases(31.9%) between 7 and 12 years of age, 56 cases(30.3%) between 3 and 6, 40 cases(22.2%) under 2 years, and 29 cases(15.6%) over 13 years of age. 3) The common symptoms of 117 cases of isolated ventricular septal defect showed frequent upper respiratory tract illness 86 cases(73.5%), exertional dyspnea 75 cases(64.1%), growth retardation 23 cases(19.6%), and palpitation 12 cases(10.2%). 4) The common physical findings included systolic murmur in all cases on the third and forth intercostal space on auscultation, systolic thrill in 69 cases(58.9%), hepatomegaly in 41 cases(35.0%), protrusion of anterior chest wall in 31cases(26.4%) and cyanosis in 6cases(5.2%). 5) The electrocardiographic findings showed LVH 45 cases(34.8%), RH 19cases(16.2%) and no ventricular hypertrophy 15 cases(12.8%). The correlation to electrocardiographic findings and right ventricular systolic pressure showed mean pressure of 28.2 mmHg in normal EKG patterns, 45.9mmHg in LVH, 59.6mmHg in BVH, and 77.6mmHg in RVH. 6) On cardiac catheterization of 117 cases of isolated ventricular septal defect, the ratio of systolic prressure of main pulmonary artery(Pp/Ps) was in 76 cases(64.9%) below 45%, 20 cases(17.1%) between 45 and 75%, and 21 cases(18.0%) over 75%. Pulmonary artery systolic pressure was under 30mmHg in many cases in older children; 15 cases between 3 and 6 years of age, 20 cases between 7 and 12, 8 cases over 13 years old. 7) The cardiac disease associated with ventricular septal defect were 65 cases in all; 31cases of pulmonary stenosis, 10 cases of aortic insufficiency, 6 cases of atrial septal defect and 2 cases of persistent left superior vena cava. |
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