Uncorrected Ventricular Septal Defect Complicated by Severe Pulmonary Arterial Hypertension, Pulmonary Embolism, and Nephrotic Syndrome in a Young Adult: A Case Report from the Borgou Departmental University Hospital, Benin (2025)
Introduction: Uncorrected ventricular septal defects can progress to severe complications in adulthood, including pulmonary arterial hypertension and Eisenmenger syndrome. In subSaharan Africa, late diagnosis remains common.
Case Presentation: A 31-year-old man was admitted for exertional dyspnea and lower limb edema. Physical examination revealed a continuous systolic-diastolic murmur and signs of right heart failure. Laboratory tests showed severe renal failure (creatinine: 101.96 mg/L), nephrotic syndrome (hypoalbuminemia: 15.03 g/L, massive proteinuria), and an inflammatory syndrome. Transthoracic echocardiography revealed a 10-12 mm perimembranous ventricular septal defect with severe pulmonary arterial hypertension, right ventricular dilatation and hypertrophy, and intracardiac thrombi. Management involved multidisciplinary medical care, with surgical intervention being contraindicated due to fixed pulmonary hypertension.
Conclusion: This case illustrates the adverse outcome of untreated ventricular septal defects and underscores the importance of early screening and correction of congenital heart diseases in subSaharan Africa.