Revelation of an asymptomatic ventricular septal defect in elderly patient before a surgical intervention

Area of Science:

• Cardiology
• Adult Congenital Heart Disease
• Geriatric Cardiology

Background:

• Congenital cardiac defects can remain asymptomatic and undetected for years.
• Ventricular septal defects (VSDs) comprise approximately 10% of adult congenital heart disease cases.
• VSDs in individuals over 80 years old are exceptionally rare, with only two prior reports in living patients.

Observation:

• A case of an asymptomatic ventricular septal defect (VSD) is presented in an 83-year-old Italian male.
• The VSD was incidentally discovered prior to inguinal hernia repair surgery.
• Associated conditions included interventricular septal hypertrophy, aortic regurgitation, and mitral stenosis with regurgitation.

Findings:

• This represents the third reported instance of a VSD found in a living patient over 80 years of age.
• The defect was asymptomatic, underscoring the variable clinical presentation of congenital heart disease.
• The patient's complex cardiac profile included significant valvular and septal abnormalities.

Implications:

• This case expands the limited literature on extremely elderly individuals with VSDs.
• It emphasizes the need for thorough cardiac evaluation, even in asymptomatic elderly patients presenting for unrelated procedures.
• Further research may elucidate the long-term natural history and management strategies for VSDs in the very old.