What are the key clinical signs and symptoms of Ventricular Septal Defect (VSD) in children that should prompt further investigation?

Key clinical signs and symptoms of ventricular septal defect (VSD) in children that should prompt further investigation include:

• Presence of a characteristic pansystolic murmur heard best at the lower left sternal border, often accompanied by a palpable thrill.
• Signs of heart failure such as tachypnoea, poor feeding, failure to thrive, and diaphoresis, especially during feeding in infants.
• Recurrent respiratory infections or increased work of breathing, which may indicate pulmonary overcirculation due to left-to-right shunting.
• Hepatomegaly and signs of volume overload in more severe cases.
• In some cases, cyanosis may develop if pulmonary hypertension progresses to Eisenmenger physiology, although this is less common in early childhood.

These clinical features warrant prompt echocardiographic assessment to confirm the diagnosis and evaluate the size and haemodynamic significance of the defect, guiding management decisions ¹ (Liu et al., 2018; Chowdhury et al., 2022).