Assessment 

On assessment a child with ventricular septal defect will show clinical manifestations depending upon the size of  the defect. The small defects are usually asymptomatic where as in medium size or large defects child will present with dyspnoea, tachypnoea, slow physical development, feeding difficulties, frequent pulmonary infections and sometimes cardiac failure may also occur. There is hypertrophy of  right side of  the heart and there may be mild cyanosis when infant cries or has infection. 

Diagnostic evaluation includes cardiac catheterization which reveals abnormal communication between ventricles, increased blood oxygenation  and pressure in the right ventricle and an obstruction at the pulmonary artery. The extent of pulmonary hypertension can also be determined. X-ray in large shunt showsenlargement of both ventricles, dilation of pulmonary artery and increased pulmonary vascular markings. ECG shows biventricular hypertrophy.