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Heart Failure from VSD — RACP Paediatrics MCQ

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ModerateCardiologyHeart Failure from VSDRACP Paediatrics

A 6-month-old infant with a large VSD has failure to thrive, tachypnoea at rest (RR 60/min), and hepatomegaly. He is on maximum medical therapy. What is the next management step?

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Correct answer: A — Refer for surgical VSD closure

A large VSD with heart failure symptoms unresponsive to medical therapy (diuretics, ACE inhibitors, nutrition optimisation) requires surgical closure. Delay increases the risk of pulmonary vascular disease. In most centres, primary VSD closure is performed rather than pulmonary artery banding.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Ventricular Septal Defect