Severe pulmonary hypertension associated with a small ventricular septal defect.

A case of progressive pulmonary hypertension in a child with a small ventricular septal defect is presented. Natural history studies have indicated that children with small ventricular septal defects can be followed conservatively. This case represents a contradiction to that rule and suggests that further study must be directed toward defining the etiology of pulmonary hypertension in patients with congenital heart disease.