Evaluation of Left to Right Shunts by the Pediatrician: How to Follow, When to Refer for Intervention?

Left to right shunts are the most common congenital heart defects which may cause increased pulmonary blood flow leading to dilatation of cardiac chambers, congestive heart failure, pulmonary artery hypertension and eventually Eisenmenger's syndrome. Many children are, however, referred late for correction making them either high risk for intervention or inoperable. The device closure of atrial septal defect, ventricular septal defect and patent ductus arteriosus can literally cure the patient for life, without a scar on the chest. Hence, it is important for every pediatrician to know how to follow and when to refer the patients with left to right shunts for either device closure or surgical intervention, so that the patient can lead a near normal life.